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肩袖修复术后肩部力量、盂肱关节活动度与临床疗效之间的关联。

Associations among shoulder strength, glenohumeral joint motion, and clinical outcome after rotator cuff repair.

作者信息

Peltz Cathryn D, Haladik Jeffrey A, Hoffman Scott E, McDonald Michael, Ramo Nicole, Moutzouros Vasilios, Bey Michael J

机构信息

Bone and Joint Center, Henry Ford Hospital, Detroit, MI.

出版信息

Am J Orthop (Belle Mead NJ). 2014 May;43(5):220-6.

Abstract

Rotator cuff tears are a common condition causing pain and disability, but the relationships among clinical measures of shoulder function and measures of glenohumeral joint (GHJ) function are not well known. In the study reported here, dynamic in vivo GHJ motion was measured during abduction from biplane radiographs in 22 rotator cuff repair (RCR) patients and 36 control subjects. Isometric shoulder strength was measured and clinical outcomes were assessed using the Western Ontario Rotator Cuff (WORC) Index. Associations among WORC, GHJ motion, and several shoulder strength ratios were assessed with linear regression. An association was detected between higher ER/ABD (external rotation/coronal-plane abduction) strength ratio and a humerus positioned more inferiorly relative to the glenoid in control subjects and RCR patients. Higher ER/ABD strength ratio was also associated with better clinical outcome in RCR patients. These findings suggest a relationship between ER/ABD strength ratio and a more centrally located average superior/inferior contact center in RCR patients and control subjects. The ER/ABD strength ratio can be easily measured in a clinical setting and therefore can be used in larger studies to investigate its relation to clinical outcomes over time or perhaps to predict superior migration of the humeral head.

摘要

肩袖撕裂是一种导致疼痛和功能障碍的常见病症,但肩功能的临床测量指标与盂肱关节(GHJ)功能测量指标之间的关系尚不清楚。在本报告的研究中,对22例肩袖修复(RCR)患者和36例对照受试者进行双平面X线片拍摄,测量外展过程中体内GHJ的动态运动。测量等长肩部力量,并使用西安大略肩袖(WORC)指数评估临床结果。通过线性回归评估WORC、GHJ运动和几个肩部力量比值之间的关联。在对照受试者和RCR患者中,较高的外旋/冠状面外展(ER/ABD)力量比值与相对于关节盂位置更低的肱骨相关。较高的ER/ABD力量比值也与RCR患者更好的临床结果相关。这些发现表明,在RCR患者和对照受试者中,ER/ABD力量比值与更居中的平均上下接触中心之间存在关联。ER/ABD力量比值可以在临床环境中轻松测量,因此可用于更大规模的研究,以调查其与随时间变化的临床结果的关系,或者可能用于预测肱骨头的上移。

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本文引用的文献

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In Vivo Measurement of Glenohumeral Joint Contact Patterns.肩肱关节接触模式的体内测量
EURASIP J Adv Signal Process. 2010 Jan 1;2010. doi: 10.1155/2010/162136.
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Systematic review: nonoperative and operative treatments for rotator cuff tears.系统评价:肩袖撕裂的非手术与手术治疗。
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