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网球运动是退行性肩部疾病的诱发因素吗?一项针对前精英运动员的对照研究。

Is tennis a predisposing factor for degenerative shoulder disease? A controlled study in former elite players.

作者信息

Maquirriain J, Ghisi J P, Amato S

机构信息

High Performance National Training Centre (CeNARD), Argentine Tennis Association, Buenos Aires, Argentina.

出版信息

Br J Sports Med. 2006 May;40(5):447-50. doi: 10.1136/bjsm.2005.023382.

Abstract

BACKGROUND

High demands imposed to the shoulder during tennis activity can decrease the efficiency of static and dynamic constraints. Subtle or frank instability of the glenohumeral joint may occur, and long term degenerative changes may be expected.

OBJECTIVE

To determine and compare the prevalence of primary glenohumeral osteoarthritis in senior tennis players and matched controls.

STUDY DESIGN

Cross sectional controlled study.

METHODS

18 asymptomatic senior tennis players were studied (17 male; mean (SD) age, 57.2 (8.8) years) with no history of shoulder surgery or major trauma. There were 18 matched controls. Radiographs were used to determine glenohumeral osteoarthritic changes: joint space narrowing, humeral and glenoid subchondral sclerosis, humeral and glenoid juxta-articular cysts, osteophytes, humeral and glenoid flattening, humeral posterior displacement and glenoid posterior erosion. Findings were classified as normal, minimal, moderate, or severe changes.

RESULTS

33% of the players (95% confidence interval (CI), 13% to 59%) had osteoarthritic changes in their dominant shoulder (n = 6; five with minimal changes, one with moderate changes), and 11% of the controls (95% CI, 1% to 34%) had articular degeneration on their dominant side (n = 2; both minimal changes) (p = 0.04, Wilcoxon test). The osteoarthritic group was significantly older than the players without degenerative changes (p = 0.008).

CONCLUSIONS

The prevalence of glenohumeral osteoarthritis in the dominant shoulder was greater in former elite tennis players than in sedentary controls. Prolonged intensive tennis practice may be a predisposing factor for the development of mild degenerative articular changes in the dominant shoulder.

摘要

背景

网球运动对肩部的高要求会降低静态和动态约束的效率。肩肱关节可能会出现细微或明显的不稳定,并且可能会出现长期的退行性变化。

目的

确定并比较老年网球运动员和匹配对照组中原发性肩肱关节骨关节炎的患病率。

研究设计

横断面对照研究。

方法

对18名无症状的老年网球运动员进行研究(17名男性;平均(标准差)年龄,57.2(8.8)岁),他们无肩部手术或重大创伤史。有18名匹配的对照组。使用X线片确定肩肱关节骨关节炎的变化:关节间隙变窄、肱骨和肩胛盂软骨下硬化、肱骨和肩胛盂关节周围囊肿、骨赘、肱骨和肩胛盂变平、肱骨后移位和肩胛盂后侵蚀。将结果分类为正常、轻度、中度或重度变化。

结果

33%的运动员(95%置信区间(CI),13%至59%)在其优势肩出现骨关节炎变化(n = 6;5例为轻度变化,1例为中度变化),11%的对照组(95%CI,1%至34%)在其优势侧出现关节退变(n = 2;均为轻度变化)(p = 0.04,Wilcoxon检验)。骨关节炎组的年龄显著大于无退行性变化的运动员(p = 0.008)。

结论

前精英网球运动员优势肩的肩肱关节骨关节炎患病率高于久坐不动的对照组。长期高强度的网球训练可能是优势肩发生轻度退行性关节变化的一个诱发因素。

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