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Erschienen in: Osteoporosis International 11/2014

01.11.2014 | Original Article

The measurement of bone mineral density of bilateral proximal humeri using DXA in patients with unilateral rotator cuff tear

verfasst von: J. H. Oh, B. W. Song, S. H. Kim, J.-A. Choi, J. W. Lee, S. W. Chung, T.-Y. Rhie

Erschienen in: Osteoporosis International | Ausgabe 11/2014

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Abstract

Summary

We propose that the measurement of the bone mineral density (BMD) of the proximal humerus be standardized using the dual energy X-ray absorptiometry (DXA) in patients supposed to undergo rotator cuff repair surgery as well as those with the fracture of the proximal humerus as the BMD of the proximal humerus is decreased in these patients.

Introduction

We propose that the measurement of the BMD of the proximal humerus be standardized using the DXA in patients who are supposed to undergo rotator cuff repair surgery as well as those with the fracture of the proximal humerus.

Methods

We conducted the prospective study in 213 patients with unilateral rotator cuff tear but without contralateral shoulder pain or disease. In these patients, we preoperatively measured the BMD of the bilateral proximal humeri with a repeat measurement in 20 patients. We predefined three regions of interest (ROIs) in the proximal humerus with the consideration of the rotator cuff repair surgery as well as proximal humeral fractures.

Results

The measurement of the BMD of the proximal humerus using the DXA showed excellent reliability (intraclass correlation coefficient > .90). BMD values of all three ROIs in the affected shoulder were significantly lower than those in asymptomatic shoulder (all p < 0.05). In female patients, the BMD values of ROIs in bilateral shoulder were significantly lower than those in male patients (all p < 0.001). In multiple regressions, however, there were no significant correlations between other clinical characteristics, except for the gender, and the BMD of GT in the affected shoulder.

Conclusions

It is imperative that the bone quality of the proximal humerus be accurately evaluated prior to surgery in patients who are supposed to undergo rotator cuff repair using suture anchors as well as in those with proximal humeral fractures. This is because the BMD of the proximal humerus is decreased in these patients.
Literatur
1.
Zurück zum Zitat Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S (1988) Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am 70:1224–1230PubMed Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S (1988) Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am 70:1224–1230PubMed
2.
Zurück zum Zitat Burkhart SS, Lo IK (2006) Arthroscopic rotator cuff repair. J Am Acad Orthop Surg 14:333–346PubMed Burkhart SS, Lo IK (2006) Arthroscopic rotator cuff repair. J Am Acad Orthop Surg 14:333–346PubMed
3.
Zurück zum Zitat Vitale MA, Kleweno CP, Jacir AM, Levine WN, Bigliani LU, Ahmad CS (2007) Training resources in arthroscopic rotator cuff repair. J Bone Joint Surg Am 89:1393–1398PubMedCrossRef Vitale MA, Kleweno CP, Jacir AM, Levine WN, Bigliani LU, Ahmad CS (2007) Training resources in arthroscopic rotator cuff repair. J Bone Joint Surg Am 89:1393–1398PubMedCrossRef
4.
Zurück zum Zitat Tingart MJ, Apreleva M, Zurakowski D, Warner JJ (2003) Pullout strength of suture anchors used in rotator cuff repair. J Bone Joint Surg Am 85-A:2190–2198PubMed Tingart MJ, Apreleva M, Zurakowski D, Warner JJ (2003) Pullout strength of suture anchors used in rotator cuff repair. J Bone Joint Surg Am 85-A:2190–2198PubMed
5.
Zurück zum Zitat Galatz LM, Rothermich SY, Zaegel M, Silva MJ, Havlioglu N, Thomopoulos S (2005) Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss. J Orthop Res 23:1441–1447PubMedCrossRef Galatz LM, Rothermich SY, Zaegel M, Silva MJ, Havlioglu N, Thomopoulos S (2005) Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss. J Orthop Res 23:1441–1447PubMedCrossRef
6.
Zurück zum Zitat Cadet ER, Hsu JW, Levine WN, Bigliani LU, Ahmad CS (2008) The relationship between greater tuberosity osteopenia and the chronicity of rotator cuff tears. J Shoulder Elbow Surg 17:73–77PubMedCrossRef Cadet ER, Hsu JW, Levine WN, Bigliani LU, Ahmad CS (2008) The relationship between greater tuberosity osteopenia and the chronicity of rotator cuff tears. J Shoulder Elbow Surg 17:73–77PubMedCrossRef
7.
Zurück zum Zitat Meyer DC, Fucentese SF, Koller B, Gerber C (2004) Association of osteopenia of the humeral head with full-thickness rotator cuff tears. J Shoulder Elbow Surg 13:333–337PubMedCrossRef Meyer DC, Fucentese SF, Koller B, Gerber C (2004) Association of osteopenia of the humeral head with full-thickness rotator cuff tears. J Shoulder Elbow Surg 13:333–337PubMedCrossRef
8.
Zurück zum Zitat Tingart MJ, Apreleva M, Lehtinen J, Zurakowski D, Warner JJ (2004) Anchor design and bone mineral density affect the pull-out strength of suture anchors in rotator cuff repair: which anchors are best to use in patients with low bone quality? Am J Sports Med 32:1466–1473PubMedCrossRef Tingart MJ, Apreleva M, Lehtinen J, Zurakowski D, Warner JJ (2004) Anchor design and bone mineral density affect the pull-out strength of suture anchors in rotator cuff repair: which anchors are best to use in patients with low bone quality? Am J Sports Med 32:1466–1473PubMedCrossRef
9.
Zurück zum Zitat Denard PJ, Burkhart SS (2011) Techniques for managing poor quality tissue and bone during arthroscopic rotator cuff repair. Arthroscopy 27:1409–1421PubMedCrossRef Denard PJ, Burkhart SS (2011) Techniques for managing poor quality tissue and bone during arthroscopic rotator cuff repair. Arthroscopy 27:1409–1421PubMedCrossRef
10.
Zurück zum Zitat Burkhart SS (1995) The deadman theory of suture anchors: observations along a south Texas fence line. Arthroscopy 11:119–123PubMedCrossRef Burkhart SS (1995) The deadman theory of suture anchors: observations along a south Texas fence line. Arthroscopy 11:119–123PubMedCrossRef
11.
Zurück zum Zitat Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, Boileau P, de Peretti F (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res : OTSR 98:715–719PubMedCrossRef Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, Boileau P, de Peretti F (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res : OTSR 98:715–719PubMedCrossRef
12.
Zurück zum Zitat Lee YS, Mihata T, Oh JH (2013) Anatomically reproducible assessment of volumetric bone mineral density–based on clinical computed tomography. J Biomech 46:767–772PubMedCrossRef Lee YS, Mihata T, Oh JH (2013) Anatomically reproducible assessment of volumetric bone mineral density–based on clinical computed tomography. J Biomech 46:767–772PubMedCrossRef
13.
Zurück zum Zitat Doetsch AM, Faber J, Lynnerup N, Watjen I, Bliddal H, Danneskiold-Samsoe B (2002) Bone mineral density measurement over the shoulder region. Calcif Tissue Int 71:308–314PubMedCrossRef Doetsch AM, Faber J, Lynnerup N, Watjen I, Bliddal H, Danneskiold-Samsoe B (2002) Bone mineral density measurement over the shoulder region. Calcif Tissue Int 71:308–314PubMedCrossRef
14.
Zurück zum Zitat Marchetti ME, Houde JP, Steinberg GG, Crane GK, Goss TP, Baran DT (1996) Humeral bone density losses after shoulder surgery and immobilization. J Shoulder Elbow Surg 5:471–476PubMedCrossRef Marchetti ME, Houde JP, Steinberg GG, Crane GK, Goss TP, Baran DT (1996) Humeral bone density losses after shoulder surgery and immobilization. J Shoulder Elbow Surg 5:471–476PubMedCrossRef
15.
Zurück zum Zitat Okamura K, Ozaki J (1999) Bone mineral density of the shoulder joint in frozen shoulder. Arch Orthop Trauma Surg 119:363–367PubMedCrossRef Okamura K, Ozaki J (1999) Bone mineral density of the shoulder joint in frozen shoulder. Arch Orthop Trauma Surg 119:363–367PubMedCrossRef
16.
Zurück zum Zitat Park JY, Kim MH (2004) Changes in bone mineral density of the proximal humerus in Koreans: suture anchor in rotator cuff repair. Orthopedics 27:857–861PubMed Park JY, Kim MH (2004) Changes in bone mineral density of the proximal humerus in Koreans: suture anchor in rotator cuff repair. Orthopedics 27:857–861PubMed
17.
Zurück zum Zitat Saitoh S, Nakatsuchi Y, Latta L, Milne E (1994) Distribution of bone mineral density and bone strength of the proximal humerus. J Shoulder Elbow Surg 3:234–242PubMedCrossRef Saitoh S, Nakatsuchi Y, Latta L, Milne E (1994) Distribution of bone mineral density and bone strength of the proximal humerus. J Shoulder Elbow Surg 3:234–242PubMedCrossRef
18.
Zurück zum Zitat Wilson J, Bonner TJ, Head M, Fordham J, Brealey S, Rangan A (2009) Variation in bone mineral density by anatomical site in patients with proximal humeral fractures. J Bone Joint Surg (Br) 91:772–775CrossRef Wilson J, Bonner TJ, Head M, Fordham J, Brealey S, Rangan A (2009) Variation in bone mineral density by anatomical site in patients with proximal humeral fractures. J Bone Joint Surg (Br) 91:772–775CrossRef
19.
Zurück zum Zitat Gulotta LV, Rodeo SA (2009) Growth factors for rotator cuff repair. Clin Sports Med 28:13–23PubMedCrossRef Gulotta LV, Rodeo SA (2009) Growth factors for rotator cuff repair. Clin Sports Med 28:13–23PubMedCrossRef
20.
Zurück zum Zitat Walter SD, Eliasziw M, Donner A (1998) Sample size and optimal designs for reliability studies. Stat Med 17:101–110PubMedCrossRef Walter SD, Eliasziw M, Donner A (1998) Sample size and optimal designs for reliability studies. Stat Med 17:101–110PubMedCrossRef
21.
Zurück zum Zitat Oh JH, Kim SH, Kang JY, Oh CH, Gong HS (2010) Effect of age on functional and structural outcome after rotator cuff repair. Am J Sports Med 38:672–678PubMedCrossRef Oh JH, Kim SH, Kang JY, Oh CH, Gong HS (2010) Effect of age on functional and structural outcome after rotator cuff repair. Am J Sports Med 38:672–678PubMedCrossRef
22.
Zurück zum Zitat Chung SW, Oh JH, Gong HS, Kim JY, Kim SH (2011) Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors. Am J Sports Med 39:2099–2107PubMedCrossRef Chung SW, Oh JH, Gong HS, Kim JY, Kim SH (2011) Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors. Am J Sports Med 39:2099–2107PubMedCrossRef
23.
Zurück zum Zitat Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 78–83 Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 78–83
24.
Zurück zum Zitat Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S (2003) Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg 12:550–554PubMedCrossRef Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S (2003) Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg 12:550–554PubMedCrossRef
25.
Zurück zum Zitat Anderson VB (2011) The intra-rater reliability of measured thoracic spine mobility in chronic rotator cuff pathology. J Musculoskelet Neuronal Interactions 11:314–319 Anderson VB (2011) The intra-rater reliability of measured thoracic spine mobility in chronic rotator cuff pathology. J Musculoskelet Neuronal Interactions 11:314–319
26.
Zurück zum Zitat Gluer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5:262–270PubMedCrossRef Gluer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5:262–270PubMedCrossRef
27.
Zurück zum Zitat Vazquez E, Song LY, Dawson-Hughes B (2004) Precision of bone mineral density scans at the proximal tibia in osteoarthritic subjects. J Clin Densitom : Off J Int Soc Clin Densitom 7:364–367CrossRef Vazquez E, Song LY, Dawson-Hughes B (2004) Precision of bone mineral density scans at the proximal tibia in osteoarthritic subjects. J Clin Densitom : Off J Int Soc Clin Densitom 7:364–367CrossRef
28.
Zurück zum Zitat Sievanen H, Kannus P, Oja P, Vuori I (1993) Precision of dual energy X-ray absorptiometry in the upper extremities. Bone Miner 20:235–243PubMedCrossRef Sievanen H, Kannus P, Oja P, Vuori I (1993) Precision of dual energy X-ray absorptiometry in the upper extremities. Bone Miner 20:235–243PubMedCrossRef
29.
Zurück zum Zitat Tothill P, Hannan WJ (2007) Precision and accuracy of measuring changes in bone mineral density by dual-energy X-ray absorptiometry. Osteoporos Int 18:1515–1523PubMedCrossRef Tothill P, Hannan WJ (2007) Precision and accuracy of measuring changes in bone mineral density by dual-energy X-ray absorptiometry. Osteoporos Int 18:1515–1523PubMedCrossRef
30.
Zurück zum Zitat Horton JA, Murray GM, Spadaro JA, Margulies BS, Allen MJ, Damron TA (2003) Precision and accuracy of DXA and pQCT for densitometry of the rat femur. J Clin Densitom : Off J Int SociClin Densitom 6:381–390CrossRef Horton JA, Murray GM, Spadaro JA, Margulies BS, Allen MJ, Damron TA (2003) Precision and accuracy of DXA and pQCT for densitometry of the rat femur. J Clin Densitom : Off J Int SociClin Densitom 6:381–390CrossRef
31.
Zurück zum Zitat Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY (2000) Measurement precision of body composition variables using the lunar DPX-L densitometer. J Clin Densitom : Off J Int Soc Clin Densitom 3:35–41CrossRef Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY (2000) Measurement precision of body composition variables using the lunar DPX-L densitometer. J Clin Densitom : Off J Int Soc Clin Densitom 3:35–41CrossRef
32.
Zurück zum Zitat Henzell S, Dhaliwal S, Pontifex R, Gill F, Price R, Retallack R, Prince R (2000) Precision error of fan-beam dual X-ray absorptiometry scans at the spine, hip, and forearm. J Clin Densitom : Off J Int Soc Clin Densitom 3:359–364CrossRef Henzell S, Dhaliwal S, Pontifex R, Gill F, Price R, Retallack R, Prince R (2000) Precision error of fan-beam dual X-ray absorptiometry scans at the spine, hip, and forearm. J Clin Densitom : Off J Int Soc Clin Densitom 3:359–364CrossRef
33.
Zurück zum Zitat Rothney MP, Martin FP, Xia Y et al (2012) Precision of GE Lunar iDXA for the measurement of total and regional body composition in nonobese adults. J Clin Densitom : Off J Int Soc Clin Densitom 15:399–404CrossRef Rothney MP, Martin FP, Xia Y et al (2012) Precision of GE Lunar iDXA for the measurement of total and regional body composition in nonobese adults. J Clin Densitom : Off J Int Soc Clin Densitom 15:399–404CrossRef
34.
Zurück zum Zitat Barber FA, Feder SM, Burkhart SS, Ahrens J (1997) The relationship of suture anchor failure and bone density to proximal humerus location: a cadaveric study. Arthroscopy 13:340–345PubMedCrossRef Barber FA, Feder SM, Burkhart SS, Ahrens J (1997) The relationship of suture anchor failure and bone density to proximal humerus location: a cadaveric study. Arthroscopy 13:340–345PubMedCrossRef
35.
Zurück zum Zitat Kirchhoff C, Braunstein V, Milz S, Sprecher CM, Fischer F, Tami A, Ahrens P, Imhoff AB, Hinterwimmer S (2010) Assessment of bone quality within the tuberosities of the osteoporotic humeral head: relevance for anchor positioning in rotator cuff repair. Am J Sports Med 38:564–569PubMedCrossRef Kirchhoff C, Braunstein V, Milz S, Sprecher CM, Fischer F, Tami A, Ahrens P, Imhoff AB, Hinterwimmer S (2010) Assessment of bone quality within the tuberosities of the osteoporotic humeral head: relevance for anchor positioning in rotator cuff repair. Am J Sports Med 38:564–569PubMedCrossRef
36.
Zurück zum Zitat Waldorff EI, Lindner J, Kijek TG, Downie BK, Hughes RE, Carpenter JE, Miller BS (2011) Bone density of the greater tuberosity is decreased in rotator cuff disease with and without full-thickness tears. J Shoulder Elbow Surg 20:904–908PubMedCrossRef Waldorff EI, Lindner J, Kijek TG, Downie BK, Hughes RE, Carpenter JE, Miller BS (2011) Bone density of the greater tuberosity is decreased in rotator cuff disease with and without full-thickness tears. J Shoulder Elbow Surg 20:904–908PubMedCrossRef
37.
Zurück zum Zitat Mantila Roosa SM, Hurd AL, Xu H, Fuchs RK, Warden SJ (2012) Age-related changes in proximal humerus bone health in healthy, white males. Osteoporos Int 23:2775–2783PubMedCrossRefPubMedCentral Mantila Roosa SM, Hurd AL, Xu H, Fuchs RK, Warden SJ (2012) Age-related changes in proximal humerus bone health in healthy, white males. Osteoporos Int 23:2775–2783PubMedCrossRefPubMedCentral
38.
Zurück zum Zitat Khodadadyan-Klostermann C, von Seebach M, Taylor WR, Duda GN, Haas NP (2004) Distribution of bone mineral density with age and gender in the proximal tibia. Clin Biomech (Bristol, Avon) 19:370–376CrossRef Khodadadyan-Klostermann C, von Seebach M, Taylor WR, Duda GN, Haas NP (2004) Distribution of bone mineral density with age and gender in the proximal tibia. Clin Biomech (Bristol, Avon) 19:370–376CrossRef
39.
Zurück zum Zitat Diederichs G, Korner J, Goldhahn J, Linke B (2006) Assessment of bone quality in the proximal humerus by measurement of the contralateral site: a cadaveric analyze. Arch Orthop Trauma Surg 126:93–100PubMedCrossRef Diederichs G, Korner J, Goldhahn J, Linke B (2006) Assessment of bone quality in the proximal humerus by measurement of the contralateral site: a cadaveric analyze. Arch Orthop Trauma Surg 126:93–100PubMedCrossRef
40.
Zurück zum Zitat Groll O, Lochmuller EM, Bachmeier M, Willnecker J, Eckstein F (1999) Precision and intersite correlation of bone densitometry at the radius, tibia and femur with peripheral quantitative CT. Skeletal Radiol 28:696–702PubMedCrossRef Groll O, Lochmuller EM, Bachmeier M, Willnecker J, Eckstein F (1999) Precision and intersite correlation of bone densitometry at the radius, tibia and femur with peripheral quantitative CT. Skeletal Radiol 28:696–702PubMedCrossRef
41.
Zurück zum Zitat Nordin BE, Chatterton BE, Schultz CG, Need AG, Horowitz M (1996) Regional bone mineral density interrelationships in normal and osteoporotic postmenopausal women. J Bone Miner Res 11:849–856PubMedCrossRef Nordin BE, Chatterton BE, Schultz CG, Need AG, Horowitz M (1996) Regional bone mineral density interrelationships in normal and osteoporotic postmenopausal women. J Bone Miner Res 11:849–856PubMedCrossRef
42.
Zurück zum Zitat Tingart MJ, Bouxsein ML, Zurakowski D, Warner JP, Apreleva M (2003) Three-dimensional distribution of bone density in the proximal humerus. Calcif Tissue Int 73:531–536PubMedCrossRef Tingart MJ, Bouxsein ML, Zurakowski D, Warner JP, Apreleva M (2003) Three-dimensional distribution of bone density in the proximal humerus. Calcif Tissue Int 73:531–536PubMedCrossRef
43.
Zurück zum Zitat Krappinger D, Bizzotto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS (2011) Predicting failure after surgical fixation of proximal humerus fractures. Injury 42:1283–1288PubMedCrossRef Krappinger D, Bizzotto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS (2011) Predicting failure after surgical fixation of proximal humerus fractures. Injury 42:1283–1288PubMedCrossRef
44.
Zurück zum Zitat Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 88:1699–1704PubMedCrossRef Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 88:1699–1704PubMedCrossRef
45.
Zurück zum Zitat Kummer FJ, Perkins R, Zuckerman JD (1998) The use of the bicipital groove for alignment of the humeral stem in shoulder arthroplasty. J Shoulder Elbow Surg 7:144–146PubMedCrossRef Kummer FJ, Perkins R, Zuckerman JD (1998) The use of the bicipital groove for alignment of the humeral stem in shoulder arthroplasty. J Shoulder Elbow Surg 7:144–146PubMedCrossRef
Metadaten
Titel
The measurement of bone mineral density of bilateral proximal humeri using DXA in patients with unilateral rotator cuff tear
verfasst von
J. H. Oh
B. W. Song
S. H. Kim
J.-A. Choi
J. W. Lee
S. W. Chung
T.-Y. Rhie
Publikationsdatum
01.11.2014
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 11/2014
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2795-1

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