Hurschler C, Wülker N, Mendila M
Department of Orthopaedic Surgery, Medical School of Hannover, Orthopädische Klinik der MHH, Annastift Klinik II, Heimchenstr. 1-7, D-30625, Hannover, Germany.
Clin Biomech (Bristol). 2000 Jun;15(5):306-14. doi: 10.1016/s0268-0033(99)00088-1.
The objective of this study was to determine the effect of negative pressure in the intraarticular space and subacromial bursa, as well as rotator cuff force, on glenohumeral translation during active elevation.
Glenohumeral translation during elevation in the scapular plane was measured under greater than, less than, and equal to physiologic rotator cuff muscle force, as well as with and without the subacromial bursa and intraarticular space vented.
Negative intraarticular pressure has been shown to help stabilize the glenohumeral joint in passive motion, although the effect on translation during active motion has not been investigated.
Eight cadaverous human shoulder specimens were tested in a dynamic shoulder simulator. Forces in the muscles of the rotator as well as the middle deltoid muscle were simulated using servohydraulic cylinders. Joint motion was measured using an ultrasonic motion analysis system.
Superior translation of the humerus increased 1.2 mm (SD, 0.4) upon venting of the bursa, and 2.1 mm (SD, 1.7) upon venting of the joint capsule at 25 degrees of glenohumeral elevation in the scapular plane. At 90 degrees elevation, venting the bursa did not change superior translation but increased anterior translation 1.04 mm (SD, 1.0). Venting of the joint capsule increased superior translation by 2.8 mm (SD, 2.5). Decreasing rotator cuff force increased superior translation, while reducing it did not.
The muscles of the rotator cuff and the negative pressure of the intraarticular space and the subacromial bursa stabilize the glenohumeral joint since they restrict translation in the superior and anterior directions. RelevanceIncreased glenohumeral translation and the resulting asymmetric loading may lead to arthrosis and ultimately rotator cuff arthropathy.
本研究的目的是确定关节内空间和肩峰下囊内的负压以及肩袖力对主动抬高过程中盂肱关节平移的影响。
在大于、小于和等于生理肩袖肌力的情况下，以及在肩峰下囊和关节内空间通气和不通气的情况下，测量肩胛骨平面抬高过程中的盂肱关节平移。
尽管尚未研究关节内负压对主动运动时平移的影响，但已表明其有助于在被动运动中稳定盂肱关节。
在动态肩部模拟器中测试了八个尸体人类肩部标本。使用伺服液压缸模拟旋转肌以及三角肌中部的肌肉力量。使用超声运动分析系统测量关节运动。
在肩胛骨平面内盂肱关节抬高25度时，囊通气后肱骨上移增加1.2毫米（标准差，0.4），关节囊通气后增加2.1毫米（标准差，1.7）。在抬高90度时，囊通气并未改变上移，但前向平移增加1.04毫米（标准差，1.0）。关节囊通气使上移增加2.8毫米（标准差，2.5）。降低肩袖力会增加上移，而减小肩袖力则不会。
肩袖肌肉以及关节内空间和肩峰下囊的负压可稳定盂肱关节，因为它们限制了向上和向前方向的平移。相关性盂肱关节平移增加以及由此产生的不对称负荷可能导致关节病，并最终导致肩袖关节病。
