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累及回旋套索带的部分厚度撕裂会导致盂肱关节运动学异常。

Partial-thickness tears involving the rotator cable lead to abnormal glenohumeral kinematics.

作者信息

Pinkowsky Gregory J, ElAttrache Neal S, Peterson Alexander B, Akeda Masaki, McGarry Michelle H, Lee Thay Q

机构信息

Kerlan-Jobe, Los Angeles, CA, USA.

Kerlan-Jobe, Los Angeles, CA, USA.

出版信息

J Shoulder Elbow Surg. 2017 Jul;26(7):1152-1158. doi: 10.1016/j.jse.2016.12.063. Epub 2017 Mar 27.

Abstract

HYPOTHESIS

The objective of this study was to determine the biomechanical function of the rotator cable when a partial-thickness (>50%) tear is present. We compared intact specimens with partial tears of the anterior cable followed by partial anterior and posterior tears in regard to glenohumeral kinematics and translation. The hypothesis was that partial-thickness tears will lead to abnormal glenohumeral biomechanics, including glenohumeral translation and path of glenohumeral articulation.

METHODS

Five fresh frozen cadaveric shoulders with intact labrum, rotator cuff, and humerus were tested using a custom shoulder testing system in the scapular plane. Glenohumeral translation was measured after applying an anterior load of 30 N at different angles of external rotation. The path of glenohumeral articulation was measured by calculating the humeral head center with respect to the glenoid articular surface at 30°, 60°, 90°, and 120° of external rotation.

RESULTS

With an anterior force of 30 N, there was a significant increase in anterior and total translation at 30° of external rotation after the anterior cable was cut (P < .05). When the tear was extended to the posterior cable, there was a significant increase in anterior, inferior, and total translation at 30° and 120° of external rotation (P < .05). With respect to the path of glenohumeral articulation , the humeral head apex was shifted superiorly at 90° and 120° of external rotation after the posterior cable was cut (P < .05).

CONCLUSION

Partial-thickness articular-sided rotator cuff tears with a thickness >50% involving the rotator cable increased glenohumeral translation and changed kinematics in our cadaveric biomechanical model.

摘要

假设

本研究的目的是确定存在部分厚度(>50%)撕裂时旋转索带的生物力学功能。我们将完整标本与前索带部分撕裂以及前、后索带均部分撕裂的标本在盂肱关节运动学和移位方面进行了比较。假设是部分厚度撕裂会导致盂肱关节生物力学异常,包括盂肱关节移位和盂肱关节活动路径异常。

方法

使用定制的肩部测试系统在肩胛平面测试五个新鲜冷冻的尸体肩部,这些肩部的盂唇、肩袖和肱骨均完整。在不同外旋角度施加30 N的前向负荷后测量盂肱关节移位。通过计算在30°、60°、90°和120°外旋时肱骨头中心相对于肩胛骨关节面的位置来测量盂肱关节活动路径。

结果

施加30 N的前向力时,切断前索带后在30°外旋时前向移位和总移位显著增加(P < 0.05)。当撕裂扩展到后索带时,在30°和120°外旋时前向、下向和总移位显著增加(P < 0.05)。关于盂肱关节活动路径,切断后索带后在90°和120°外旋时肱骨头顶点向上移位(P < 0.05)。

结论

在我们的尸体生物力学模型中,厚度>50%且累及旋转索带的关节侧部分厚度肩袖撕裂增加了盂肱关节移位并改变了运动学。

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