ABSTRACT
BACKGROUND: Rotator cuff injury is the most common type of shoulder joint injury. So far, there are few studies on the relationship between local osteoporosis of the greater tuberosity of the humerus and rotator cuff tears in China. The bone mineral density (BMD) in the footprint area is a key factor affecting the intraoperative anchor placement. The recovery of BMD after operation is worth further study. OBJECTIVE: To compare preoperative and postoperative BMD of the bilateral greater tuberosity of the humerus and analyze the improvement of BMD after arthroscopic rotator cuff suture. METHODS: Data of 37 patients with unilateral rotator cuff injury who received arthroscopic suture in the Department of Joint Surgery of the Affiliated Hospital of Chengde Medical College were retrospectively analyzed. There were 16 males and 21 females. The average age was 55.8 years (age range: 35-73 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. BMD of the bilateral greater tuberosity of the humerus measured by dual-energy X-ray absorptiometry was collected, and the relationship between the course of disease, tendon retraction and the difference of BMD before and 1 year after surgery was analyzed. RESULTS AND CONCLUSION: The BMD difference of the bilateral greater tuberosity of the humerus in the mild retraction group was significantly lower than that in the moderate and severe retraction group (P < 0.05), and the BMD difference in the acute mild retraction group was significantly lower than that in the chronic moderate and severe retraction group (P < 0.05). The local osteoporosis of the greater tuberosity was severer in the patients with chronic moderate and severe retraction. During 1-year follow-up after surgery, the BMD difference of the 37 patients was significantly lower than that before surgery (P < 0.05). The BMD difference had no significant difference in the mild retraction group before and after surgery, while in the moderate and severe retraction group, the BMD difference was significantly lowered after surgery (P < 0.05). The BMD difference in the chronic moderate and severe retraction group was significantly lowered after surgery (P < 0.05). At the last follow-up, imaging examination showed no re-tears in all the enrolled patients. To conclude, local osteoporosis of the greater tuberosity is the most obvious in rotator cuff injury with chronic moderate to severe tendon retraction. Arthroscopic repair of rotator cuff injury under shoulder arthroscopy can restore local bone substance to a certain extent, regardless of the course of the disease.