In vivo evaluation of rotator cuff internal impingement during scapular plane abduction in asymptomatic individuals.
In vivo evaluation of rotator cuff internal impingement during scapular plane abduction in asymptomatic individuals.
复制标题
无症状个体肩胛平面外展期间肩袖内部撞击的体内评估。
DOI：
10.1002/jor.25423
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Bey,MichaelJ
中科院分区：
文献类型：
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作者：
Lawrence,RebekahL;Soliman,StevenB;Roseni,Kevin;Zauel,Roger;Bey,MichaelJ
内部撞击-或在头顶活动过程中肩袖肌腱下表面对关节盂的截留-被认为是导致关节侧撕裂的原因。然而，很少有人知道内部撞击以外的运动人群。因此，本研究的目的是（1）描述无症状个体在动态体内运动期间的关节盂-足印距离和邻近中心，以及（2）确定肩袖撕裂和未撕裂个体之间这些测量值的差异程度。在肩胛平面外展过程中，使用高速双平面X线摄影系统对37名无症状个体的肩关节运动学进行了评估。通过将运动学与计算机断层扫描衍生骨模型相结合，计算关节盂至足迹距离和邻近中心位置。当最小距离小于估计的盂唇厚度时，假设发生关节盂-足印接触。使用超声评估冈上肌腱的状况（完整、撕裂）。使用双因素混合模型方差分析，比较了不同肩胸仰角（90°、110°、130°、150°）和冈上肌病理组之间的最小距离和邻近中心。关节盂到足印面的最小距离在不同仰角下一致降低（p< 0.01），组间无显著差异。估计所有参与者都发生了接触。近端中心通常位于肩袖足迹的前半部分和后上关节盂上。临床意义声明：头顶运动期间的内部撞击可能是肩袖病理学的一种普遍机制，因为接触似乎很常见，并且涉及肩袖足印区域，认为该区域是退行性肩袖撕裂的起源。
Internal impingement—or entrapment of the undersurface of the rotator cuff tendon against the glenoid during overhead activities—is believed to contribute to articular‐sided tears. However, little is known about internal impingement outside athletic populations. Therefore, the objectives of this study were to (1) describe glenoid‐to‐footprint distances and proximity centers during dynamic, in vivo motion in asymptomatic individuals, and (2) determine the extent to which these measures differed between individuals with and without a rotator cuff tear. Shoulder kinematics were assessed in 37 asymptomatic individuals during scapular plane abduction using a high‐speed biplane radiographic system. Glenoid‐to‐footprint distances and proximity center locations were calculated by combining the kinematics with computerized tomography‐derived bone models. Glenoid‐to‐footprint contact was presumed to occur when the minimum distance was less than the estimated labral thickness. The condition of the supraspinatus tendon (intact, torn) was assessed using ultrasound. Minimum distances and proximity centers were compared over humerothoracic elevation angles (90°, 110°, 130°, 150°) and between supraspinatus pathology groups using two‐factor mixed model analysis of variances. Glenoid‐to‐footprint minimum distances decreased consistently across elevation angles (p< 0.01) without a significant difference between groups. Contact was estimated to occur in all participants. Proximity centers were generally located on the anterior half of the rotator cuff footprint and on the posterosuperior glenoid. Statement of Clinical Significance: Internal impingement during overhead motions may be a prevalent mechanism of rotator cuff pathology as contact appears to be common and involves the region of the rotator cuff footprint where degenerative rotator cuff tears are thought to originate.