Sarver Joseph J, Peltz Cathryn D, Dourte LeAnn, Reddy Sudheer, Williams Gerald R, Soslowsky Louis J
McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1 Suppl):108S-113S. doi: 10.1016/j.jse.2007.08.004.
Although rotator cuff repair is often successful at relieving pain, the repaired insertion site frequently fails. Mechanical properties of the repair improved when the shoulder was immobilized in an animal model, but joint stiffness and range of motion were not evaluated. The objective of this study was to measure rotational mechanics before and after shoulders were immobilized after cuff injury and repair, not immobilized after cuff injury and repair, and immobilized without injury and repair. Humeral rotation was significantly less 4 and 8 weeks after injury and repair but did not decrease significantly when the injured and repaired shoulder was immobilized. Rotational stiffness increased significantly 4 and 8 weeks after injury and repair and was significantly greater at 4, but not 8, weeks when the injured and repaired shoulders were immobilized. This study demonstrated that the increase in joint stiffness caused by immobilizing an injured and repaired shoulder was transient and, therefore, does not outweigh the long-term benefits of immobilization on improved tendon to bone healing.
尽管肩袖修复术通常能成功缓解疼痛，但修复后的附着点常常失败。在动物模型中，当肩部固定时，修复的力学性能有所改善，但未评估关节僵硬程度和活动范围。本研究的目的是测量在肩袖损伤和修复后固定肩部、肩袖损伤和修复后不固定肩部以及未损伤和修复而固定肩部这三种情况下，旋转力学在前后的变化。损伤和修复后4周及8周时，肱骨旋转明显减少，但当受伤并修复的肩部固定时，肱骨旋转并未显著降低。损伤和修复后4周及8周时，旋转刚度显著增加，且在受伤并修复的肩部固定4周时旋转刚度显著更大，但8周时并非如此。本研究表明，固定受伤并修复的肩部所导致的关节僵硬增加是短暂的，因此，其并不超过固定对改善肌腱与骨愈合的长期益处。
