Ueda Yasuyuki, Tanaka Hiroshi, Morioka Shigetoshi, Tachibana Takashi, Hayashi Toyohiko, Ichihashi Noriaki, Inui Hiroaki, Nobuhara Katsuya
Department of Rehabilitation, Nobuhara Hospital, 720 Haze, Issai-cho, Tatsuno-city, Hyogo, Japan; Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan.
Institute of Biomechanics, Nobuhara Hospital, 720 Haze, Issai-cho, Tatsuno-city, Hyogo, Japan.
Clin Biomech (Bristol). 2019 Mar;63:207-213. doi: 10.1016/j.clinbiomech.2019.03.012. Epub 2019 Mar 19.
Function loss caused by rotator cuff tears alters the scapular orientation, however, few prior studies have reported on scapular movements after rotator cuff repair. The purpose was to determine the scapular orientations before and after rotator cuff repair.
We recruited 14 healthy controls, 10 small and six massive rotator cuff tear in patients. The scapular upward rotation during arm elevation was analyzed using fluoroscopic imaging.
Before surgery, both rotator cuff groups demonstrated greater scapular upward rotation compared to healthy controls. Two months postoperation, the analyses showed significant differences between the patients with small rotator cuff tears and healthy controls at arm elevations of 90°, and between patients with both rotator cuff tear groups and healthy controls at arm elevations of 120°. At five months post-operation, significant differences still existed between the healthy controls and both rotator cuff groups. In regard to the temporal effects in the patients with small rotator cuff tears, the scapular upward rotation decreased significantly over time (2-5 months postoperation) at arm elevations of 120°. We did not identify a main effect owing to time in the patients with massive rotator cuff tears.
In patients with small rotator cuff tears, scapular upward rotation was reduced over the period of 2-5 months postoperation, however, the patients with massive rotator cuff tears showed greater scapular upward rotation throughout the experimental period. The results suggested that the execution of the rehabilitation program should consider that the tear size could affect scapular motion.
肩袖撕裂导致的功能丧失会改变肩胛骨的方向，然而，此前很少有研究报道肩袖修复术后的肩胛骨运动情况。本研究旨在确定肩袖修复术前和术后的肩胛骨方向。
我们招募了14名健康对照者、10名肩袖小撕裂患者和6名肩袖大撕裂患者。使用荧光透视成像分析手臂抬高过程中肩胛骨的向上旋转情况。
术前，与健康对照者相比，两个肩袖撕裂组的肩胛骨向上旋转幅度均更大。术后两个月，分析显示，在手臂抬高90°时，肩袖小撕裂患者与健康对照者之间存在显著差异；在手臂抬高120°时，两个肩袖撕裂组患者与健康对照者之间均存在显著差异。术后五个月，健康对照者与两个肩袖撕裂组之间仍存在显著差异。对于肩袖小撕裂患者的时间效应，在手臂抬高120°时，肩胛骨向上旋转随时间（术后2至5个月）显著降低。我们未发现肩袖大撕裂患者存在时间主效应。
在肩袖小撕裂患者中，术后2至5个月期间肩胛骨向上旋转减少，然而，肩袖大撕裂患者在整个实验期间肩胛骨向上旋转幅度更大。结果表明，康复计划的实施应考虑到撕裂大小可能影响肩胛骨运动。
