Lubiatowski Przemysław, Długosz Jan, Ślęzak Marta, Ogrodowicz Piotr, Stefaniak Jakub, Walecka Joanna, Romanowski Leszek
Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.
Rehasport Clinic, Poznań, Poland.
Int Orthop. 2017 Jan;41(1):149-155. doi: 10.1007/s00264-016-3275-3. Epub 2016 Aug 19.
The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift).
Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011. Group I received arthroscopic Bankart repair, group; II - arthroscopic anterior capsular plication, control group - subacromial decompression. Joint volume was measured by fluid aspiration into the syringe via arthroscope, before and after procedure. Then volume reduction potential was calculated.
The following average values of initial joint volume were recorded: group I - 26.8 ml group II - 43.7 ml and the control group - 25.6 ml with significant differences: impingement vs. instability + laxity (p < 0.00001), impingement vs. instability without laxity (p = 0.0001). There was no significant difference between groups I and II. Joint volume was significantly reduced after labral repair (by average of 37 %, 13.8 ml, p < 0.0001). Capsular shift led to an even greater and more significant volume decrease (61 %, 26.7 ml, p < 0.001). Joint volume in the control group was reduced only by 11 %, 3.8 ml (p = 0.046).
Patients with unstable shoulders have enlarged joint volume as compared to patients with subacromial impingement. Arthroscopic techniques lead to a significant joint volume reduction, with the most powerful effect for capsular shift. Level of Evidence - Level 2.
评估不稳定（伴或不伴松弛）和稳定肩关节（肩峰下撞击症）的盂肱关节容积以及关节镜技术的容积减少潜力（盂唇锚钉修复术与关节囊移位术）。
研究材料基于2010 - 2011年接受手术的133例患者：无松弛的前肩关节不稳定（I组，n = 49）、有松弛的前肩关节不稳定（II组，n = 22）和肩峰下撞击症（对照组，n = 62）。I组接受关节镜下Bankart修复术，II组接受关节镜下前关节囊折叠术，对照组接受肩峰下减压术。在手术前后，通过关节镜将液体抽吸到注射器中来测量关节容积。然后计算容积减少潜力。
记录到初始关节容积的以下平均值：I组 - 26.8毫升，II组 - 43.7毫升，对照组 - 25.6毫升，存在显著差异：撞击症与不稳定+松弛（p < 0.00001），撞击症与无松弛的不稳定（p = 0.0001）。I组和II组之间无显著差异。盂唇修复术后关节容积显著减少（平均减少37%，即13.8毫升，p < 0.0001）。关节囊移位导致更大且更显著的容积减少（61%，即26.7毫升，p < 0.001）。对照组的关节容积仅减少11%，即3.8毫升（p = 0.046）。
与肩峰下撞击症患者相比，不稳定肩关节患者的关节容积增大。关节镜技术可导致关节容积显著减少，其中关节囊移位术效果最为显著。证据级别 - 2级。
