McMahon Patrick J, Burkart Andreas, Musahl Volker, Debski Richard E
Musculoskeletal Research Center, Tecnical University of Munich, Munich, Germany.
J Shoulder Elbow Surg. 2004 Jan-Feb;13(1):39-44. doi: 10.1016/j.jse.2003.09.004.
The effects of simulated type II superior labrum anterior-posterior (SLAP) lesions were studied to determine whether the severity of the lesion affected glenohumeral joint translations. A robotic/universal force-moment sensor testing system was used to simulate load-and-shift tests by applying an anterior or posterior load of 50 N to each shoulder. The apprehension test for anterior instability was simulated by applying an anterior load of 50 N with an external rotation torque of 3 Nm at 30 degrees and 60 degrees of abduction. This loading protocol was repeated after creating two type II SLAP lesions of different severity. In the first the superior labrum and the biceps anchor were elevated subperiosteally from the glenoid bone (SLAP-II-1), and in the second the biceps anchor was completely detached (SLAP-II-2). Statistical analysis was performed with a 2-factor repeated-measures analysis of variance followed by multiple contrasts, and the significance level was set at P <.05. At 30 degrees of abduction, anterior translation of the vented joint from anterior loading was 18.5 +/- 8.5 mm. It was significantly increased (26.2 +/- 6.5 mm, P =.03), after the SLAP-II-2 lesion and compared with the SLAP-II-1 lesion (25.0 +/- 6.8 mm, P =.03). Increases in anterior translations at 60 degrees of abduction were not significantly differ in comparison to the two SLAP lesions. Inferior translation also resulted from anterior loading. At 30 degrees of abduction in the vented joint, it was 3.8 +/- 4.0 mm and was significantly increased (8.5 +/- 5.4 mm, P =.05) after the SLAP-II-2 lesion, no different than that after the SLAP-II-1 lesion (7.8 +/- 4.9 mm). No significant increases in anterior translation occurred in response to the combined loading condition between the two SLAP lesions. Glenohumeral translation was increased, regardless of severity, after simulation of type II SLAP lesions. During stabilizing surgical interventions, passive stabilizers that are injured in the type II SLAP lesion should be considered as well as dynamic activity in the tendon of the long head of the biceps brachii.
研究了模拟Ⅱ型上盂唇前后（SLAP）损伤的影响，以确定损伤的严重程度是否会影响盂肱关节的平移。使用机器人/通用力-力矩传感器测试系统，通过对每个肩部施加50N的前向或后向负荷来模拟负荷-移位试验。通过在30度和60度外展时施加50N的前向负荷和3Nm的外旋扭矩来模拟前向不稳定的恐惧试验。在制造两个不同严重程度的Ⅱ型SLAP损伤后，重复该加载方案。在第一个损伤中，上盂唇和肱二头肌锚从肩胛盂骨膜下抬高（SLAP-II-1），在第二个损伤中，肱二头肌锚完全分离（SLAP-II-2）。采用双因素重复测量方差分析并进行多重对比进行统计分析，显著性水平设定为P<0.05。在30度外展时，前向负荷导致的关节前向平移为18.5±8.5mm。在SLAP-II-2损伤后，与SLAP-II-1损伤（25.0±6.8mm，P = 0.03）相比，其显著增加（26.2±6.5mm，P = 0.03）。在60度外展时，与两种SLAP损伤相比，前向平移的增加无显著差异。前向负荷也导致了下向平移。在30度外展的关节中，其为3.8±4.0mm，在SLAP-II-2损伤后显著增加（8.5±5.4mm，P = 0.05），与SLAP-II-1损伤后（7.8±4.9mm）无差异。在两种SLAP损伤之间的联合加载条件下，前向平移没有显著增加。模拟Ⅱ型SLAP损伤后，无论严重程度如何，盂肱关节平移均增加。在稳定手术干预期间，应考虑Ⅱ型SLAP损伤中受损的被动稳定器以及肱二头肌长头肌腱的动态活动。
