腱板断裂肩における手術後の肩甲関節窩面の応力分布

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There have been no reports that have analyzed changes of the stress distribution in postoperative glenoid cavity using CTOAM. The aim of this study was to investigate change of long-term stress distribution at the subchondral bone of the glenoid cavity after rotator cuff surgery. 9 shoulders in 8 cases with rotator cuff surgery were investigated pre- and post-operatively using CT osteoabsorptiometry (CTOAM). The average age of the patients was 66.3 years old (range: 45-82). 7 shoulders had anterior acromioplasty with a rotator cuff reconstruction and the remaining 2 shoulders had only anterior acromioplasty. The average duration between pre- and post-CT examination was 70.6 months (range: 39-90). The measured Hounsfield Unit values at the subchondral bone plate were mapped in 256 phases of gray scale using custom-made software. Anterior-superior maximum type was found in 3 glenoids, anterior-superior and posterior type in 4 and central maximum with anterior-superior maximum type in 2 before surgery. After surgery, 6 of 7 shoulders which had received rotator cuff reconstruction revealed an increase of stress distribution at the central area of glenoid. The stress distribution at the subchondral bone of glenoid cavity in patients without rotator cuff reconstruction had not changed. In a rotator cuff tear shoulder, stress was concentrated on the anterior-superior and posterior-superior zone by upward deviation of the head of the humerus. After reconstruction of rotator cuff, long-term mechanical stresses were concentrated into the central region and only anterior acromioplasty did not lead to an antero-superior stress distribution.

腱板断裂肩における手術後の肩甲関節窩面の応力分布

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