title: The measurement of bone mineral density of bilateral proximal humeri using DXA in patients with unilateral rotator cuff tear.
abstract: 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.
  
  
  BACKGROUND
  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.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Oh
authors.forename: B W
authors.initials: BW
authors.lastname: Song
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: J-A
authors.initials: JA
authors.lastname: Choi
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
authors.forename: S W
authors.initials: SW
authors.lastname: Chung
authors.forename: T-Y
authors.initials: TY
authors.lastname: Rhie
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D006811:Humerus / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010024:Osteoporosis / Q000175:diagnosis* / Q000209:etiology; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012737:Sex Factors; D012784:Shoulder Fractures / Q000175:diagnosis / Q000503:physiopathology