Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, Fukuoka, Japan.
J Orthop Surg (Hong Kong). 2020 Sep-Dec;28(3):2309499020981779. doi: 10.1177/2309499020981779.
Assessment of scapular kinematics and the dynamics of the scapulohumeral rhythm (SHR) would be important for understanding pathologies of the shoulder and to inform treatment. Our aim in this study was to evaluate the SHR and scapular kinematics in patients with a rotator cuff tear (RCT), compared to a control group with healthy shoulders using image-matching techniques.
The shoulder kinematics of large or massive RCT patients were evaluated and compared to a control group with healthy shoulders. Radiographic surveillance was performed throughout the full range of external rotation and scapular plane abduction. Computed tomography imaging of the shoulder complex was performed, with three-dimensional image reconstruction and matching to the radiographs to measure three-dimensional positions and orientations. SHR and angular values of the scapula were measured.
Scapular external rotation in the late phase of external rotation movement was greater in the RCT group than in the control group ( < 0.05), but with no difference in the SHR. During scapular plane abduction, there were significant differences in SHR, scapular posterior tilt and scapular upward rotation between the RCT and control group ( < 0.05).
Regarding clinical relevance, this study clarified the differences of SHR and angular values of the scapula between the RCT and control group. These results underline the importance of assessment the SHR and scapular kinematics in individuals with a RCT. RCT is associated with specific compensation in the kinematics of the scapula and SHR during external rotation and scapular plane abduction, which could inform treatment.
评估肩胛骨运动学和肩胛骨运动节律（SHR）的动力学对于理解肩部病理学以及为治疗提供信息非常重要。我们本研究的目的是使用图像匹配技术，评估肩袖撕裂（RCT）患者与健康肩部对照组之间的 SHR 和肩胛骨运动学。
评估了大或巨大 RCT 患者的肩部运动学，并与健康肩部的对照组进行比较。对整个外旋和肩胛骨平面外展的全范围进行放射学监测。对肩部复合体进行计算机断层扫描成像，并进行三维图像重建和与 X 光片匹配，以测量三维位置和方向。测量 SHR 和肩胛骨的角度值。
在外部旋转运动的后期，RCT 组的肩胛骨外旋角度大于对照组（<0.05），但 SHR 没有差异。在肩胛骨平面外展过程中，RCT 和对照组之间 SHR、肩胛骨后倾和肩胛骨上旋的角度值存在显著差异（<0.05）。
就临床相关性而言，本研究阐明了 RCT 组和对照组之间 SHR 和肩胛骨角度值的差异。这些结果强调了在肩袖撕裂患者中评估 SHR 和肩胛骨运动学的重要性。RCT 与外旋和肩胛骨平面外展过程中肩胛骨运动和 SHR 的特定代偿有关，这可能为治疗提供信息。
