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比较解剖型和反式肩关节置换术后的每日肩部活动度和频率。

Comparing daily shoulder motion and frequency after anatomic and reverse shoulder arthroplasty.

机构信息

Investigations performed at the Roth|McFarlane Hand and Upper Limb Center, London, ON, Canada.

Investigations performed at the Roth|McFarlane Hand and Upper Limb Center, London, ON, Canada.

出版信息

J Shoulder Elbow Surg. 2018 Feb;27(2):325-332. doi: 10.1016/j.jse.2017.09.023. Epub 2017 Nov 10.

Abstract

BACKGROUND

Both anatomic (TSA) and reverse total shoulder arthroplasty (RTSA) are common interventions for glenohumeral arthrosis, with the goal of relieving pain and restoring mobility. Understanding shoulder arthroplasty motion and frequency is of interest in evaluating effectiveness and in predicting bearing wear for implant development and optimization. The purpose of this study was to measure and compare the total daily shoulder motion of patients after TSA and RTSA.

METHODS

Thirty-six human subjects who had undergone shoulder arthroplasty wore a custom instrumented garment that tracked upper extremity motion for the waking hours of 1 day. The 3-dimensional orientation of each humeral sensor was transformed with respect to the torso to calculate total joint motion and frequency, with comparison of TSA to RTSA. In addition, the yearly motion of the shoulder was extrapolated.

RESULTS

The majority of shoulder motion occurred below 80° of elevation (P < .001), totaling on average 821 ± 45 and 783 ± 27 motions per hour for TSA and RTSA, respectively. Conversely, elevations >80° were significantly less frequent, totaling only 52 ± 44 (P < .001) and 38 ± 27 (P < .001) motions per hour for TSA and RTSA, respectively. No significant differences were detected between TSA and RTSA shoulders (P = .22) or their respective contralateral asymptomatic sides (P = .64, P = .62). When extrapolated, it was estimated that each TSA and RTSA shoulder elevated above 60° approximately 1 million and 0.75 million cycles per year, respectively.

DISCUSSION

Mean shoulder motions after TSA or RTSA were not significantly different from the contralateral asymptomatic side. In addition, no significant differences were detected in shoulder motion or frequency between TSA and RTSA.

摘要

背景

解剖型全肩关节置换术(TSA)和反式全肩关节置换术(RTSA)均为治疗肩关节炎的常见手术,旨在缓解疼痛并恢复活动度。了解肩关节置换术后的运动和频率对于评估手术效果和预测假体磨损以进行植入物开发和优化非常重要。本研究旨在测量和比较 TSA 和 RTSA 后患者的总日肩运动。

方法

36 名接受过肩关节置换术的患者佩戴了定制的仪器化服装,该服装可在 1 天的清醒时间内跟踪上肢运动。每个肱骨传感器的三维方向相对于躯干进行转换,以计算总关节运动和频率,并比较 TSA 与 RTSA。此外,还 extrapolated 了肩部的年运动。

结果

大多数肩部运动发生在 80°以下(P < .001),TSA 和 RTSA 每小时的平均运动次数分别为 821±45 和 783±27。相反,80°以上的运动频率明显较低,TSA 和 RTSA 每小时的运动次数分别仅为 52±44(P < .001)和 38±27(P < .001)。TSA 和 RTSA 肩部(P = .22)或其相应的无症状对侧肩部(P = .64,P = .62)之间未检测到显著差异。当 extrapolated 时,估计每个 TSA 和 RTSA 肩部每年升高超过 60°约 100 万和 0.75 万次。

讨论

TSA 或 RTSA 后平均肩部运动与无症状对侧无显著差异。此外,在 TSA 和 RTSA 之间未检测到肩部运动或频率的显著差异。

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