title: Does bone density of the greater tuberosity change in patients over 70?
abstract: BACKGROUND
  There are no published studies on bone density of the greater tuberosity of the humerus, which could influence the stability of reinsertion by suture anchors. The goal of our study was to determine the influence of age, gender and the type of tear on the quality of bone in the greater tuberosity.
  
  
  METHODS
  Ninety-eight patients over the age of 60 were included, 41 without a rotator cuff tear and 57 with an isolated stage 1 or 2 supraspinatus tear and fatty infiltration (FI) ≤ 2. The areas of measurement included cancellous bone located under the cortex of the greater tuberosity. Measurements were obtained either across from the tear or from the middle facet with greater tuberosity if the cuff was not torn. We measured average, maximum and minimum bone density and the standard deviation (SD) in each region with Osirix software.
  
  
  RESULTS
  The two groups were similar for age (73), investigated side and mean densities (0.282 g/cm(2) vs 0.210 g/cm(2)). Age over 70 was a predictive factor for osteoporosis of the greater tuberosity whether or not a rotator cuff tear was present (P<0.0001). There was less trabecular bone in women with cuff tears (P=0.009). Stage 2 cuff retraction was predictive of osteoporosis of the greater tuberosity (P=0.0001).
  
  
  CONCLUSIONS
  This is the first study in the literature to evaluate bone density of the greater tuberosity in relation to the presence or not of a rotator cuff tear in an elderly population. Female gender, age over 70 and stage 2 cuff retraction are factors responsible for osteoporosis of the greater tuberosity of the humeral head. The osteoporosis is not severe, and normally the quality of bone of the greater tuberosity should not limit stability of suture anchors.
  
  
  METHODS
  3.
authors.affiliation: CCOM-CHU Strasbourg, 10, avenue Achille-Baumann, 67400 Illkirch, France. Electronic address: philippe.clavert@chru-strasbourg.fr.
authors.forename: P
authors.initials: P
authors.lastname: Clavert
authors.affiliation: CCOM-CHU Strasbourg, 10, avenue Achille-Baumann, 67400 Illkirch, France.
authors.forename: J
authors.initials: J
authors.lastname: Bouchaïb
authors.affiliation: CCOM-CHU Strasbourg, 10, avenue Achille-Baumann, 67400 Illkirch, France.
authors.forename: C
authors.initials: C
authors.lastname: Sommaire
authors.affiliation: Clinique du Sport de Bordeaux-Mérignac, 9, rue Jean-Moulin, 33700 Mérignac, France.
authors.forename: P-H
authors.initials: PH
authors.lastname: Flurin
authors.affiliation: CHU Ambroise-Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France.
authors.forename: P
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000367:Age Factors; D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Bone density; CT scan; Greater tuberosity; Osteoporosis; Rotator cuff tear