Department of Orthopedics, Trauma Surgery and Paraplegiology, University of Heidelberg, Schlierbacher Landstraße 200a, Heidelberg, Germany.
Arch Orthop Trauma Surg. 2012 Jul;132(7):1003-10. doi: 10.1007/s00402-012-1495-6. Epub 2012 Mar 9.
This prospective study evaluated the development of proprioception over the course of 3 years after shoulder arthroplasty.
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.
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].
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.
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。
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。
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]。
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。
