Wuelker N, Schmotzer H, Thren K, Korell M
Orthopaedic Department, Hannover Medical School, Germany.
Clin Orthop Relat Res. 1994 Dec(309):193-200.
Translation of the glenohumeral joint was measured with a dynamic shoulder model during elevation of the arm in 8 cadaveric specimens. Controlled hydrodynamic actuator forces were applied to the deltoid muscle and the rotator cuff through wire cables. Using a constant force ratio, the glenohumeral joint was elevated to 90 degrees. The position of the arm in all spatial orientations was measured with an ultrasonic device. Reproducibility of glenohumeral joint motion was demonstrated on the basis of 5 cycles of glenohumeral joint elevation. The rotational center of the humeral head was used as the reference point for translation. Translation during elevation of the glenohumeral joint between 20 degrees and 90 degrees averaged 9.0 mm +/- 5.2 mm superiorly and 4.4 mm +/- 1.3 mm anteriorly. Physiologic variation of muscle activity, which is not yet fully understood, was not included in the model. In vivo, translation may be diminished by coordinated activity of the rotator cuff. The presence of significant glenohumeral joint translation underlines the importance of active, muscular guidance at the shoulder. Physiologic translation must be considered in the design of total shoulder arthroplasty, in shoulder instability, and in the impingement syndrome.
在8个尸体标本中，使用动态肩部模型在手臂抬高过程中测量盂肱关节的平移。通过钢丝绳向三角肌和肩袖施加可控的流体动力致动器力。以恒定的力比将盂肱关节抬高到90度。使用超声设备测量手臂在所有空间方向上的位置。基于盂肱关节抬高的5个周期证明了盂肱关节运动的可重复性。以肱骨头的旋转中心作为平移的参考点。盂肱关节在20度至90度抬高过程中的平移平均向上为9.0毫米±5.2毫米，向前为4.4毫米±1.3毫米。肌肉活动的生理变化尚未完全了解，未纳入该模型。在体内，肩袖的协调活动可能会减少平移。盂肱关节明显平移的存在突出了肩部主动肌肉引导的重要性。在全肩关节置换术的设计、肩部不稳定和撞击综合征中必须考虑生理平移。
