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Arch Orthop Trauma Surg · Oct 2019
All-arthroscopic glenoid reconstruction by iliac crest bone graft transfer does not affect structural integrity and 3-dimensional volume of the subscapularis muscle.
- Benjamin Bockmann, Arne Johannes Venjakob, Rolf Gebing, and Wolfgang Nebelung.
- Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Gudrunstraße 56, 44791, Bochum, Germany. benjamin_bockmann@hotmail.com.
- Arch Orthop Trauma Surg. 2019 Oct 1; 139 (10): 1417-1424.
AimThe subscapularis muscle is an important active stabilizer of the glenohumeral joint. For this radiological study, we investigated if its radiological integrity is affected after arthroscopic glenoid reconstruction. In the technique used, an autologous iliac crest graft is transported through the rotator interval, and the graft is fixed via an antero-inferior portal with compression screws.Methods3 women and 6 men (mean age 31 ± 9 years, min 21, max 46 years) who had a preoperative glenoid deficit of 23% ± 6% (min 13%, max 29%) were included. In a follow-up after an interval of 34 months (min 19, max 50), MRI scans were performed on both shoulders. With ITK-SNAP, a 3D reconstruction software, the volume of the subscapularis muscle in the injured and contralateral shoulder was measured. In addition, signal intensity ratios (PSI) (infraspinatus muscle / cranial subscapularis muscle and infraspinatus muscle / caudal subscapularis muscle) were analyzed and the width of the cranial and caudal portions as well as the length of the subscapularis muscle in the parasagittal plane were determined.ResultsThe 3D volume showed no difference between operated and healthy shoulders (p = 0.07), neither did PSI ratios (infraspinatus muscle / cranial subscapularis muscle: p = 1.00, infraspinatus muscle / caudal subscapularis muscle: p = 1.00). In the parasagittal plane, length (p = 0.09) and cranial width (p = 0.23) did not differ. However, the width of the lower muscle was increased in injured shoulders (p = 0.02).ConclusionIn this cohort, no relevant volume loss could be found after arthroscopic glenoid reconstruction. However, a greater width of the lower muscle portion could be identified in the parasagittal plane as a possible indication of scarring.
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