Lawrence Rebekah L, Schlangen Dustin M, Schneider Katelyn A, Schoenecker Jonathan, Senger Andrea L, Starr William C, Staker Justin L, Ellermann Jutta M, Braman Jonathan P, Ludewig Paula M
Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware Street SE, MMC 388, Minneapolis 55455, Minnesota.
Department of Radiology, University of Minnesota, Minneapolis, Minnesota.
J Orthop Res. 2017 Oct;35(10):2329-2337. doi: 10.1002/jor.23515. Epub 2017 Mar 27.
Mechanical subacromial rotator cuff compression is one theoretical mechanism in the pathogenesis of rotator cuff disease. However, the relationship between shoulder kinematics and mechanical subacromial rotator cuff compression across the range of humeral elevation motion is not well understood. The purpose of this study was to investigate the effect of humeral elevation on subacromial compression risk of the supraspinatus during a simulated functional reaching task. Three-dimensional anatomical models were reconstructed from shoulder magnetic resonance images acquired from 20 subjects (10 asymptomatic, 10 symptomatic). Standardized glenohumeral kinematics from a simulated reaching task were imposed on the anatomic models and analyzed at 0, 30, 60, and 90° humerothoracic elevation. Five magnitudes of humeral retroversion were also imposed on the models at each angle of humerothoracic elevation to investigate the impact of retroversion on subacromial proximities. The minimum distance between the coracoacromial arch and supraspinatus tendon and footprint were quantified. When contact occurred, the magnitude of the intersecting volume between the supraspinatus tendon and coracoacromial arch was also quantified. The smallest minimum distance from the coracoacromial arch to the supraspinatus footprint occurred between 30 and 90°, while the smallest minimum distance to the supraspinatus tendon occurred between 0 and 60°. The magnitude of humeral retroversion did not significantly affect minimum distance to the supraspinatus tendon except at 60 or 90° humerothoracic elevation. The results of this study provide support for mechanical rotator cuff compression as a potential mechanism for the development of rotator cuff disease. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2329-2337, 2017.
肩峰下机械性压迫肩袖是肩袖疾病发病机制中的一种理论机制。然而，在肱骨抬高运动范围内，肩部运动学与肩峰下机械性压迫肩袖之间的关系尚未完全明确。本研究的目的是在模拟功能性伸展任务中，研究肱骨抬高对冈上肌肩峰下压迫风险的影响。从20名受试者（10名无症状，10名有症状）获取的肩部磁共振图像重建三维解剖模型。将模拟伸展任务中的标准化盂肱关节运动学施加于解剖模型，并在肱骨胸段抬高0°、30°、60°和90°时进行分析。在每个肱骨胸段抬高角度，还对模型施加五种程度的肱骨后倾，以研究后倾对肩峰下接近度的影响。量化喙肩弓与冈上肌腱及附着点之间的最小距离。当发生接触时，还量化冈上肌腱与喙肩弓之间相交体积的大小。从喙肩弓到冈上肌附着点的最小距离在30°至90°之间最小，而到冈上肌腱的最小距离在0°至60°之间最小。除了在肱骨胸段抬高60°或90°时，肱骨后倾程度对到冈上肌腱的最小距离没有显著影响。本研究结果支持机械性压迫肩袖是肩袖疾病发生发展的一种潜在机制。©2017骨科研究学会。由威利期刊公司出版。《矫形外科学研究》35:2329 - 2337，2017年。
