肩胛盂倾斜角度和肱骨头向上移位的随机分析
A stochastic analysis of glenoid inclination angle and superior migration of the humeral head.
作者信息
Flieg Nicholas G, Gatti Christopher J, Doro Lisa Case, Langenderfer Joseph E, Carpenter James E, Hughes Richard E
机构信息
Laboratory for Optimization and Computation in Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Michigan, 2019 BSRB, 109 Zina Pitcher Pl., Ann Arbor, MI 48109-2200, USA.
出版信息
Clin Biomech (Bristol). 2008 Jun;23(5):554-61. doi: 10.1016/j.clinbiomech.2008.01.001. Epub 2008 Feb 14.
BACKGROUND
Superior glenoid inclination, which is a relatively upward facing of the glenoid in the plane of the scapula, has been associated with rotator cuff pathology. Increased glenoid inclination may cause superior humeral head migration, which can cause impingement of the supraspinatus tendon. The purpose of this study was to test the hypothesis that inclination angle affects the probability of superior humeral head migration.
METHODS
A three-dimensional model of the glenohumeral joint was developed in which muscle forces were modeled as random variables. Monte Carlo simulation was used to compute the probability that the glenohumeral reaction force was directed such that superior humeral head migration should occur. An electromyogram-driven model was used to estimate shoulder muscle forces in healthy volunteers performing arm elevation.
FINDINGS
The model predicted that the probability of superior humeral head migration increased as glenoid inclination angle was increased. This finding was independent of the assumed shape of the muscle force probability distributions.
INTERPRETATION
The results support the theory that glenoid inclination may be a risk factor for rotator cuff pathology.
背景
肩胛盂上倾角是指肩胛盂在肩胛骨平面内相对向上的方向，它与肩袖病变有关。肩胛盂倾斜度增加可能导致肱骨头向上移位，进而导致冈上肌腱受到撞击。本研究的目的是检验倾斜角度影响肱骨头向上移位概率这一假设。
方法
建立了一个盂肱关节的三维模型，其中肌肉力量被建模为随机变量。采用蒙特卡罗模拟计算盂肱关节反应力指向导致肱骨头向上移位的概率。使用肌电图驱动模型来估计健康志愿者进行手臂抬高时的肩部肌肉力量。
结果
该模型预测，随着肩胛盂倾斜角度的增加，肱骨头向上移位的概率也会增加。这一发现与所假设的肌肉力量概率分布形状无关。
解读
这些结果支持了肩胛盂倾斜可能是肩袖病变危险因素的理论。
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