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肩关节置换术后 3 年的三维运动分析中的本体感觉:一项前瞻性研究。

Proprioception 3 years after shoulder arthroplasty in 3D motion analysis: a prospective study.

机构信息

Department of Orthopedics, Trauma Surgery and Paraplegiology, University of Heidelberg, Schlierbacher Landstraße 200a, Heidelberg, Germany.

出版信息

Arch Orthop Trauma Surg. 2012 Jul;132(7):1003-10. doi: 10.1007/s00402-012-1495-6. Epub 2012 Mar 9.

Abstract

BACKGROUND

This prospective study evaluated the development of proprioception over the course of 3 years after shoulder arthroplasty.

METHODS

Twenty-one patients were enrolled who underwent total shoulder arthroplasty (n = 10) or hemiarthroplasty (HEMI) (n = 11) for shoulder osteoarthritis. All patients were examined 1 day before the operation, 6 months and 3 years after surgery in a motion analysis study with an active angle-reproduction (AAR) test.

RESULTS

Overall proprioception measured by the AAR deteriorated significantly 3 years after surgery [from 6.6° (SD 3.1) to 10.3° (SD 5.7); p = 0.017] and was significantly worse than in the control group [10.3° (SD 5.7) vs. 7.8° (SD 2.3); p = 0.030). In the HEMI subgroup, 3 years after shoulder replacement, there is a significant deterioration of proprioception at 30° of external rotation [from 3.1° (SD 3.5) to 12.8° (SD 10.7); p = 0.031]. On average, in the TSA subgroup proprioception deteriorated from 7.1° (SD 3.1) to 8.6° (SD 1.4) and in the HEMI subgroup from 6.1° (SD 2.1) to 12.4° (SD 8.3). The comparison of postoperative impairment of proprioception between the TSA and HEMI subgroup showed significantly worse proprioception for the HEMI subgroup at 30° of external rotation [9.8° (SD 10.1) vs. 1.6° (SD 6.3) in the TSA group; p = 0.046].

CONCLUSION

In conclusion, proprioception that was measured by an AAR test remained unchanged or deteriorated 3 years after shoulder arthroplasty. The postoperative deterioration of proprioception was more distinctive in HEMI than in TSA group.

摘要

背景

本前瞻性研究评估了肩关节置换术后 3 年内本体感觉的发展情况。

方法

共纳入 21 例因肩关节骨关节炎接受全肩关节置换术(n=10)或人工肱骨头置换术(HEMI)(n=11)的患者。所有患者均在术前 1 天、术后 6 个月和 3 年接受运动分析研究,采用主动角度再现(AAR)测试进行检查。

结果

AAR 测量的整体本体感觉在术后 3 年显著恶化[从术前的 6.6°(SD 3.1)变为术后的 10.3°(SD 5.7);p=0.017],且显著差于对照组[10.3°(SD 5.7)vs. 7.8°(SD 2.3);p=0.030]。在 HEMI 亚组中,肩关节置换术后 3 年,外旋 30°时本体感觉明显恶化[从术前的 3.1°(SD 3.5)变为术后的 12.8°(SD 10.7);p=0.031]。平均而言,TSA 亚组的本体感觉从 7.1°(SD 3.1)恶化至 8.6°(SD 1.4),HEMI 亚组从 6.1°(SD 2.1)恶化至 12.4°(SD 8.3)。TSA 和 HEMI 亚组术后本体感觉受损的比较显示,HEMI 亚组在 30°外旋时的本体感觉明显更差[9.8°(SD 10.1)vs. TSA 组的 1.6°(SD 6.3);p=0.046]。

结论

总之,AAR 测试测量的本体感觉在肩关节置换术后 3 年内保持不变或恶化。HEMI 组术后本体感觉的恶化比 TSA 组更明显。

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