Orthopaedic Robotics Laboratory, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, PA, USA.
Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2595-2605. doi: 10.1007/s00167-021-06459-1. Epub 2021 Feb 8.
Since poor repeatability of the load and shift test using a grading scale has been reported, an objective and quantitative method to assess anterior translation should be established to assess glenohumeral joint function. The purpose of this study was to assess the accuracy and repeatability of the ultrasonographic techniques to quantify anterior translation of the glenohumeral joint.
Eight fresh-frozen cadaveric shoulders were used. For the standard technique, the ultrasound transducer was positioned on the anterolateral aspect of the shoulder viewing the coracoid process, glenoid, and humeral head. For the revised technique, the transducer was positioned on the anterior aspect of the shoulder, perpendicular to the scapular plane, viewing the conjoint tendon, glenoid, and humeral head. During the load and shift test, the distance between anterior edges of the glenoid and the humeral head was measured. The difference between distances before and after applying an anterior load was calculated as an anterior translation and compared with the anterior translation assessed using a motion tracking system. The repeatability and accuracy of both techniques were analyzed statistically.
Intra- and inter-observer repeatability was good-excellent for both ultrasonographic techniques (ICC, 0.889-0.998). The revised technique achieved a stronger correlation to the anterior translations obtained using the motion tracking system (R = 0.810-0.913, p < 0.001) than the standard technique (R = 0.619-0.806, p < 0.001).
Better accuracy and repeatability was found in the revised technique than the standard technique. The revised technique will be useful to determine the individual laxity and modify the treatment plan and return-to-sports protocol.
III.
由于使用分级量表进行负荷和移位测试的重复性较差，因此应该建立一种客观和定量的方法来评估盂肱关节的前向移位，以评估肩关节功能。本研究的目的是评估超声技术定量评估盂肱关节前向移位的准确性和可重复性。
使用 8 个新鲜冷冻的尸体肩关节。对于标准技术，将超声换能器放置在肩关节的前外侧，观察喙突、肩胛盂和肱骨头。对于修正技术，将换能器放置在肩关节的前侧，垂直于肩胛平面，观察联合肌腱、肩胛盂和肱骨头。在负荷和移位测试过程中，测量肩胛盂前缘和肱骨头前缘之间的距离。计算施加前负荷前后距离的差异，作为前向移位，并与运动跟踪系统评估的前向移位进行比较。统计分析两种技术的重复性和准确性。
两种超声技术的观察者内和观察者间重复性均较好（ICC，0.889-0.998）。修正技术与运动跟踪系统获得的前向移位相关性更强（R=0.810-0.913，p<0.001），优于标准技术（R=0.619-0.806，p<0.001）。
修正技术比标准技术具有更好的准确性和重复性。修正技术将有助于确定个体的松弛度，并修改治疗计划和重返运动方案。
III。
