Wülker N, Rössig S, Korell M, Thren K
Orthopädische Klinik, Medizinischen Hochschule Hannover im Annastift e.V.
Sportverletz Sportschaden. 1995 Mar;9(1):1-8. doi: 10.1055/s-2007-993413.
Stability of the glenohumeral joint with an anterior, posterior and inferior displacement force of 50 Newton was measured in a dynamic shoulder model. Controlled hydrodynamic actuator forces were applied to the deltoid muscle and to the rotator cuff in seven anatomic specimens. During elevation of the arm, the position of the humerus was measured with a six-degree-of-freedom ultrasonic sensor device. The rotational center of the humeral head was used as reference point for translation. A displacement force of 50N led to significant humeral head displacement anteriorly and posteriorly, but not inferiorly. A 50% reduction of rotator cuff forces increased anterior displacement by 46% and posterior displacement by 31%. Venting of the glenohumeral joint space and of the subacromial bursa resulted in a 50% increase of anterior displacement, a 19% increase of posterior displacement and in significant inferior displacement. This study demonstrates that, in addition to passive stabilizers and negative intraarticular pressure, rotator cuff force significantly contributes to stabilization of the glenohumeral joint during arm motion. Muscle strength and coordination should gain more emphasis in the diagnosis and treatment of shoulder instability.
在一个动态肩部模型中，测量了肱骨头在50牛顿的前、后和下向位移力作用下的稳定性。在七个解剖标本中，通过可控的流体动力致动器向三角肌和肩袖施加力。在手臂抬高过程中，使用六自由度超声传感器装置测量肱骨的位置。肱骨头的旋转中心用作平移的参考点。50牛的位移力导致肱骨头明显向前和向后移位，但向下移位不明显。肩袖力量减少50%会使前向位移增加46%，后向位移增加31%。肱盂关节腔和肩峰下囊的排气导致前向位移增加50%，后向位移增加19%，并导致明显的向下位移。本研究表明，除了被动稳定器和关节内负压外，肩袖力量在手臂运动过程中对肱盂关节的稳定有显著贡献。在肩部不稳定的诊断和治疗中，应更加重视肌肉力量和协调性。
