title: A rotator cuff rupture produces permanent osteoporosis in the affected extremity, but not in those with whom shoulder function has returned to normal.
abstract: Areal bone mineral density (BMD) and clinical status of 34 men treated surgically 9 years earlier for a rotator cuff rupture of the dominant side shoulder were determined. The BMD was measured at the lumbar spine (L2-L4) and the proximal humerus, humeral shaft, radial shaft, ulnar shaft, distal forearm, and hand of both extremities using a dual-energy X-ray absorptiometric (DXA) scanner. Thirty-four age-, height-, weight-, and profession-matched normal men (controls) were also measured. The patients' mean side-to-side BMD difference (dominant minus nondominant/nondominant x 100%) was significantly lower in the proximal humerus (patients -3.5% vs. controls +2.4%, p = 0.0002), humeral shaft (-2.6% vs. +1.6%, p = 0.0005), radial shaft (-0.4% vs. +1.9%, p = 0.0311), distal forearm (-0.2% vs. +2.4%, p = 0.0158), and hand (+2.3% vs. +4.0%, p = 0.0047). In the ulnar shaft, this difference was almost the same in the patients (-0.2%) and controls (+0.2%) (NS). Also, the lumbar spine BMD did not differ significantly between these groups (mean +/- SD = 1.098 +/- 0.148 g/cm2 in patients vs. 1.066 +/- 0.156 g/cm2 in controls). In patients, the relative BMDs of the injured extremity did not significantly associate with the size of the rupture; time delay between the injury and the surgery; type of surgery and postoperative treatment; postoperative immobilization time; follow-up time; patient's age, muscle strength or pain assessment; and subjective assessment of shoulder function. However, they strongly associated with the objective assessment of the shoulder function: the better the observed function of the shoulder, the less bone loss caused by the injury.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Kannus
authors.forename: J
authors.initials: J
authors.lastname: Leppälä
authors.forename: M
authors.initials: M
authors.lastname: Lehto
authors.forename: H
authors.initials: H
authors.lastname: Sievänen
authors.forename: A
authors.initials: A
authors.lastname: Heinonen
authors.forename: M
authors.initials: M
authors.lastname: Järvinen
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*; D010147:Pain Measurement; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012783:Shoulder Dislocation