Takase Katsumi, Imakiire Atsuhiro, Burkhead Wayne Zealous
Department of Orthopedic Surgery, Tokyo Medical University, Japan.
J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):557-61. doi: 10.1067/mse.2002.126765.
Accurate reproduction of the anatomic relationship is important in nonconstrained prosthetic arthroplasty. However, the geometry of the glenohumeral joint for prosthetic components has not been established. In this study, we evaluated the relationship between the position of the greater tuberosity and various geometric measurements in the glenohumeral joint. Radiographs of 519 shoulders without osseous lesions were reviewed. There were 296 male and 223 female patients, with a mean age of 49.7 years. Four parameters were measured on true anteroposterior radiographs, including the distance between the humeral head-greater tuberosity junctional point and the top of the humeral head, as well as the neck shaft angle. There were significant differences in all parameters between males and females. The distance between the humeral head-greater tuberosity junctional point and the top of the humeral head significantly correlated with the neck shaft angle in both males (P <.01, r = 0.468) and females (P <.01, r = 0.639). If the neck shaft angle of the replacement is smaller than the anatomic neck shaft angle of the patient, the placement of the humeral head component with the same distance between the humeral head-greater tuberosity junctional point and the top of the humeral head as that before surgery might not reproduce the anatomic glenohumeral joint. We conclude that determining the distance between the humeral head-greater tuberosity junctional point and the top of the humeral head and its relationship to the neck shaft angle is important for the prevention of postoperative subacromial impingement.
在非限制性人工关节置换术中，准确再现解剖关系很重要。然而，用于假体部件的盂肱关节的几何形状尚未确定。在本研究中，我们评估了大结节位置与盂肱关节各种几何测量值之间的关系。回顾了519例无骨病变的肩部X线片。有296例男性和223例女性患者，平均年龄49.7岁。在真正的前后位X线片上测量了四个参数，包括肱骨头-大结节交界点与肱骨头顶部之间的距离，以及颈干角。男性和女性在所有参数上均存在显著差异。肱骨头-大结节交界点与肱骨头顶部之间的距离在男性（P <.01，r = 0.468）和女性（P <.01，r = 0.639）中均与颈干角显著相关。如果置换的颈干角小于患者的解剖颈干角，将肱骨头部件放置在肱骨头-大结节交界点与肱骨头顶部之间的距离与手术前相同，可能无法再现解剖盂肱关节。我们得出结论，确定肱骨头-大结节交界点与肱骨头顶部之间的距离及其与颈干角的关系对于预防术后肩峰下撞击很重要。
