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关节镜下 Bankart 修复术后哪些肌肉功能可以得到改善?

Which muscle performance can be improved after arthroscopic Bankart repair?

机构信息

Department of Sports Medical Center, Korea University College of Medicine Anam Hospital, Seoul, Republic of Korea.

Department of Orthopaedic Surgery, Healthpoint Hospital, Abu Dhabi, UAE.

出版信息

J Shoulder Elbow Surg. 2020 Aug;29(8):1681-1688. doi: 10.1016/j.jse.2019.12.013. Epub 2020 Mar 5.

Abstract

BACKGROUND

There are no published reports available regarding neuromuscular control recovery in nonathletic patients after arthroscopic (A/S) Bankart repair. This study aimed to compare neuromuscular control and performance of the rotator cuff muscles between patients who underwent A/S Bankart repair and normal controls.

METHODS

In total, 32 nonathletic patients who underwent A/S Bankart repair were compared with 32 asymptomatic nonathletic volunteers. Neuromuscular control index (time to peak torque and acceleration time), muscle strength ratio, muscle strength, and muscle endurance of the internal rotators (IRs) and external rotators (ERs) were measured using an isokinetic device at an angular velocity of 180°/s, with 90° shoulder abduction.

RESULTS

The neuromuscular control indices of both IRs and ERs were significantly lower in patients who underwent A/S Bankart repair than in normal controls (time to peak torque, IRs: 1059 ± 143 ms vs. 679 ± 226 ms, P = .011; ERs: 595 ± 286 ms vs. 379 ± 123 ms, P = .044; acceleration time, IRs: 75 ± 16 ms vs. 62 ± 15 ms, P = .039, ERs: 70 ± 19 ms vs. 54 ± 18 ms, P = .047). Muscle endurance was significantly lower in patients who underwent A/S Bankart repair than in normal controls (IRs: 670 ± 1 J vs. 718 ± 2 J, P = .002, ERs: 422 ± 6 J vs. 501 ± 2 J, P = .044). The neuromuscular control index showed a significant negative correlation with muscle endurance for both IRs and ERs after the operation (IRs: r = -0.737, P = .003, ERs: r = -0.617, P = .019).

CONCLUSION

Compared with normal controls, patients who underwent A/S Bankart repair did not show complete recovery of neuromuscular control of IRs and ERs, although their muscle strength ratio and muscle strength had fully recovered.

摘要

背景

目前尚无关于关节镜下(A/S)Bankart 修复后非运动员患者神经肌肉控制恢复的文献报道。本研究旨在比较 A/S Bankart 修复后患者与无症状非运动员对照组的肩袖肌肉神经肌肉控制和表现。

方法

共比较了 32 例接受 A/S Bankart 修复的非运动员患者和 32 例无症状非运动员志愿者。使用等速测力仪在 90°肩外展角下,以 180°/s 的角速度测量内旋肌(IR)和外旋肌(ER)的神经肌肉控制指数(峰值扭矩和加速时间)、肌肉力量比、肌肉力量和肌肉耐力。

结果

与正常对照组相比,接受 A/S Bankart 修复的患者的 IR 和 ER 的神经肌肉控制指数均显著降低(峰值扭矩,IR:1059 ± 143 ms 比 679 ± 226 ms,P =.011;ER:595 ± 286 ms 比 379 ± 123 ms,P =.044;加速时间,IR:75 ± 16 ms 比 62 ± 15 ms,P =.039,ER:70 ± 19 ms 比 54 ± 18 ms,P =.047)。与正常对照组相比,接受 A/S Bankart 修复的患者的肌肉耐力显著降低(IR:670 ± 1 J 比 718 ± 2 J,P =.002,ER:422 ± 6 J 比 501 ± 2 J,P =.044)。术后,IR 和 ER 的神经肌肉控制指数与肌肉耐力呈显著负相关(IR:r = -0.737,P =.003,ER:r = -0.617,P =.019)。

结论

与正常对照组相比,接受 A/S Bankart 修复的患者的 IR 和 ER 的神经肌肉控制并未完全恢复,尽管其肌肉力量比和肌肉力量已完全恢复。

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