Kinematic analysis of dynamic shoulder motion in patients with reverse total shoulder arthroplasty
Kinematic analysis of dynamic shoulder motion in patients with reverse total shoulder arthroplasty
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DOI：
10.1016/j.jse.2011.07.031
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发表时间：
2012-09-01
影响因子：
3
通讯作者：
Sheikhzadeh, Ali
中科院分区：
文献类型：
--
作者：
Kwon, Young W.;Pinto, Vivek J.;Sheikhzadeh, Ali
背景：反向全肩关节置换术（rTSA）已被用于治疗不可修复的肩袖功能障碍患者。尽管临床疗效已得到证实，但关于与该结构相关的肩关节运动学潜在变化的信息很少。因此，我们试图研究动态肩关节运动的运动学功能良好的rTSA.Methods：我们测试了12名健康受试者和17例rTSA患者。所有rTSA患者均能够将手臂抬高至至少90度，并在试验前至少6个月接受植入物作为初次关节置换术。平均而言，rTSA患者将手臂抬高至112度+/- 12度（平均值+/- SD），并报告美国肩肘外科医生结局评分为90.6 +/- 6.3。三维电磁运动捕捉设备被用来检测动态运动的躯干，肩胛骨，肱骨在双边主动肩抬高沿着矢状面，肩胛骨，冠状planes.Results：在健康和rTSA的肩膀，大多数的肱骨-胸椎运动提供的盂肱运动。因此，在沿着肩胛平面抬高期间，盂肱关节与肩胛胸廓（ST）运动的比值始终大于1.62。然而，与健康受试者相比，rTSA肩关节ST段运动对整体肩关节运动的贡献显著增加。这种增加的贡献，注意到在所有平面的肩elevation.Level的证据：基础科学研究，运动学研究时，重量附加到arm.Conclusion：Kinetics的rTSA肩关节显着改变，和更多的ST运动是用来实现肩elevation.Level的。(C)2012年《肩肘外科杂志》董事会。
Background: Reverse total shoulder arthroplasty (rTSA) has been used to treat patients with irreparable rotator cuff dysfunction. Despite the proven clinical efficacy, there is minimal information regarding the underlying changes to the shoulder kinematics associated with this construct. Therefore, we sought to examine the kinematics of dynamic shoulder motion in patients with well-functioning rTSA.Methods: We tested 12 healthy subjects and 17 patients with rTSA. All rTSA patients were able to elevate their arms to at least 90 degrees and received the implant as the primary arthroplasty at least 6 months before testing. On average, the rTSA patients elevated their arms to 112 degrees +/- 12 degrees (mean +/- SD) and reported an American Shoulder and Elbow Surgeons outcome score of 90.6 +/- 6.3. A 3-dimensional electromagnetic motion capture device was used to detect the dynamic motion of the trunk, scapula, and humerus during bilateral active shoulder elevation along the sagittal, scapular, and coronal planes.Results: In both healthy and rTSA shoulders, the majority of the humeral-thoracic motion was provided by the glenohumeral motion. Therefore, the ratio of glenohumeral to scapulothoracic (ST) motion was always greater than 1.62 during elevation along the scapular plane. In comparison to healthy subjects, however, the contribution of ST motion to overall shoulder motion was significantly increased in the rTSA shoulders. This increased contribution was noted in all planes of shoulder elevation and was maintained when weights were attached to the arm.Conclusion: Kinematics of the rTSA shoulders are significantly altered, and more ST motion is used to achieve shoulder elevation.Level of evidence: Basic Science Study, Kinesiology Study. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.