| Objectives:To compare preoperative and postoperative bone mineral density(B MD)of the bilateral greater tuberosity of the humerus and analyze the i mprovement of bone mineral density(BMD)after arthroscopic rotator c uff suture.Methods:Data of 37 patients with unilateral rotator cuff injury who received arthroscopic suture in joint surgery department of our hospital from Sptember 2017 to Sptember 2018 were retrospectively analyzed.There were 16 males and 21 females.The average age was 55.8 years.Rotator cuff injuries were classified according to Patte's degree of tendon retraction: mild retraction in 17 cases,moderate and severe retraction in 20 cases;According to the length of the disease course,13 cases were acute(< 3 months)and 12 cases were chronic(> 3 months).Collect patients with preoperative and postoperative 1 year method of determination of dual-energy X-ray absorptiometry(DXA)measurement of bilateral humerus bone mineral density(BMD)of the greater tuberosity.In the background program,we manually drew the Region of interest(ROI)of the greater tuberosity of the humerus(GT)Region.The BMD difference of bilateral greater tuberosity of the humerus(healthy BMDinjured BMD)/ healthy BMD×100% was calculated and included in the statistics.The measurement data is expressed as x?±s,and the non-normal distribution is expressed by Median and interquartile Median(IQR).Paired t test was used to compare the differences in bone mineral density of bilateral proximal humerus,and Wilcoxon rank sum test was used to compare the differences between preoperative and postoperative values.The relationship between length of disease course,degree of tendon retraction and bilateral BMD difference before and 1 year after surgery was analyzed.Results:Among the 37 patients,there was no significant difference in average age(54.8±9.48 years old)between the mild retraction group and the moderate and severe retraction group(56.6±6.33 years old,p=0.49).The BMD difference of the humeral nodules in the mild retraction group [1.174(3.409)] was significantly lower than that in the moderate and severe retraction group [6.729(5.478),p < 0.05],and the BMD difference in the acute mild retraction group [1.306(4.514)] was significantly lower than that in the chronic moderate and severe retraction group [10.700(6.830),p < 0.05].The local osteoporosis of the greater tubercle was more significant in the patients with chronic moderate and severe retraction.1 year follow-up after surgery,the BMD difference percentage of 37 patients with greater tuberosity of humerus [4.45(3.924)] was significantly lower than that before surgery [4.01(8.63),z=-2.435,p < 0.05].There was no significant difference between mild retraction group before surgery [1.174(3.409)] and postoperative [1.647(2.774),z=-0.166,P > 0.05],while moderate and severe retraction group [6.729(5.478),5.551(3.043),z=0.001,P < 0.05].The difference between preoperative [10.70(6.830)] and postoperative [5.861(3.424)in the chronic moderate and severe retraction group was significant(p < 0.05).Conclusions:The bone density of the greater tuberosity of the humerus in the patients with unilateral rotator cuff tear was significantly lower than that in the healthy side,and the local osteoporosis in the greater tuberosity region was the most obvious in the patients with rotator cuff tear with chronic and moderate to severe tendon retraction.Repair of rotator cuff injury under shoulder arthroscopy can restore local bone.Even for patients with a long course of disease and heavy tendon retraction,as long as reliable initial stability is achieved during the operation and standardized rehabilitation training is conducted after the operation,local bone is still significantly improved. |
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