肩袖前上部肌腱部分厚度撕裂对关节旋转角度范围内肩胛下肌腱应变的影响。
Effect of anterior supraspinatus tendon partial-thickness tears on infraspinatus tendon strain through a range of joint rotation angles.
机构信息
McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Shoulder Elbow Surg. 2010 Jun;19(4):617-23. doi: 10.1016/j.jse.2009.10.003. Epub 2010 Jan 15.
BACKGROUND
Rotator cuff tears are common shoulder problems whose propagation is difficult to predict because of the structural and mechanical inhomogeneity of the supraspinatus tendon. We have previously shown that the supraspinatus and infraspinatus tendons interact mechanically when the supraspinatus tendon is intact or exhibits a full-thickness tear, so that an increase in supraspinatus tendon strain is paralleled by an increase in infraspinatus tendon strain. Such interaction is critical and suggests that an increase in infraspinatus tendon strain that accompanies an increase in supraspinatus tendon strain may shield the supraspinatus tendon from further injury, but increase the risk of injury to the infraspinatus tendon. In this study, the mechanical interactions between the supraspinatus and infraspinatus tendons were evaluated for the commonly occurring supraspinatus tendon partial-thickness tears through a range of rotation angles.
METHODS
For each joint rotation and supraspinatus tendon tear size evaluated, the supraspinatus tendon was loaded, and images corresponding to 5 N, 30 N, 60 N, and 90 N of supraspinatus tendon load were isolated for the speckle painted supraspinatus and infraspinatus tendons. A region of interest outlining the insertion site was isolated and displacements between the 5 N loaded image and each of the others were measured, from which normalized average principal strains were quantified in both tendons.
RESULTS
The observed effect on infraspinatus tendon strain paralleled that observed on strain in the supraspinatus tendon. Introducing a supraspinatus tendon partial-thickness tear and increasing load caused an increase in normalized average maximum and a decrease in normalized average minimum principal strain in the infraspinatus tendon. Increasing rotation angle from internal to external rotation caused a general decrease in normalized average maximum and increase in normalized average minimum principal strain in both tendons.
CONCLUSION
The supraspinatus and infraspinatus tendons mechanically interact for the intact and partially torn supraspinatus tendons for neutral and rotated glenohumeral joint.
背景
肩袖撕裂是常见的肩部问题，由于冈上肌腱的结构和力学不均匀性，其传播很难预测。我们之前已经表明，在冈上肌腱完整或出现全层撕裂时，冈上肌和冈下肌肌腱在力学上相互作用，因此冈上肌腱应变的增加伴随着冈下肌腱应变的增加。这种相互作用是至关重要的，表明伴随冈上肌腱应变增加的冈下肌腱应变增加可能会使冈上肌腱免受进一步损伤，但会增加冈下肌腱损伤的风险。在这项研究中，通过一系列旋转角度评估了常见的冈上肌腱部分撕裂的冈上肌和冈下肌肌腱之间的力学相互作用。
方法
对于评估的每个关节旋转和冈上肌腱撕裂大小，加载冈上肌腱，并分离出冈上肌和冈下肌的斑点涂漆的 5 N、30 N、60 N 和 90 N 的冈上肌腱负荷的图像。分离出勾勒插入部位的感兴趣区域，并测量从 5 N 加载图像到其他图像的每个图像的位移，从中量化两个肌腱的归一化平均主应变。
结果
观察到的冈下肌腱应变的影响与观察到的冈上肌腱应变的影响相似。引入冈上肌腱部分撕裂并增加负荷会导致冈下肌腱的归一化平均最大和归一化平均最小主应变增加。从内旋到外旋增加旋转角度会导致两个肌腱的归一化平均最大和归一化平均最小主应变普遍减少。
结论
在中立和旋转的盂肱关节中，完整和部分撕裂的冈上肌腱的冈上肌和冈下肌肌腱在力学上相互作用。
Zotero 插件