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退行性关节炎和人工关节置换术对肩部本体感觉的影响。

The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception.

作者信息

Cuomo Frances, Birdzell Maureen Gallagher, Zuckerman Joseph D

机构信息

Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY, USA.

出版信息

J Shoulder Elbow Surg. 2005 Jul-Aug;14(4):345-8. doi: 10.1016/j.jse.2004.07.009.

Abstract

The effect of glenohumeral arthritis and subsequent total shoulder arthroplasty (TSA) on shoulder proprioception has not been evaluated previously. A prospective analysis of 20 consecutive patients with unilateral advanced glenohumeral arthritis who underwent TSA was undertaken. Shoulder proprioception testing for passive position sense and detection of motion was performed 1 week before surgery and 6 months after TSA. The presence of glenohumeral arthritis had a significant effect on position sense for all 3 planes tested (flexion, abduction, and external rotation). There were significant differences (P < .05) compared with the uninvolved shoulder and with a group of 20 age- and gender-matched subjects without a history of shoulder problems. Six months after TSA, position sense was significantly improved (P < .05) and was not significantly different from that in the contralateral shoulder or the comparison group. Detection of motion was also significantly worse in the arthritic group compared with that in the uninvolved contralateral side (P < .05). Six months after TSA, the sensitivity to detection of motion improved (P < .01) and was not significantly different than that in the uninvolved contralateral shoulder. In addition, the postoperative values for the involved shoulder were not significantly different than those in the age- and gender-matched comparison group. This study demonstrates a significant decrease in proprioceptive function in patients with advanced glenohumeral arthritis. After TSA, there was a marked improvement in proprioception.

摘要

肩肱关节关节炎及后续全肩关节置换术(TSA)对肩部本体感觉的影响此前尚未得到评估。对20例连续接受TSA的单侧晚期肩肱关节关节炎患者进行了前瞻性分析。在手术前1周和TSA术后6个月进行了肩部本体感觉测试,包括被动位置觉和运动觉检测。肩肱关节关节炎的存在对所有测试的3个平面(屈曲、外展和外旋)的位置觉均有显著影响。与未受累肩部以及一组20名年龄和性别匹配且无肩部问题病史的受试者相比,存在显著差异(P <.05)。TSA术后6个月,位置觉显著改善(P <.05),与对侧肩部或对照组相比无显著差异。与未受累的对侧相比,关节炎组的运动觉检测也明显更差(P <.05)。TSA术后6个月,运动觉检测的敏感性提高(P <.01),与未受累的对侧肩部无显著差异。此外,受累肩部的术后值与年龄和性别匹配的对照组相比无显著差异。本研究表明,晚期肩肱关节关节炎患者的本体感觉功能显著下降。TSA术后,本体感觉有明显改善。

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