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Mechanism of Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder

下囊移位手术治疗肩部多向不稳定性的机制

基本信息

批准号：
12671392
负责人：
ITOI Eiji
金额：
$ 0.58万
依托单位：
Akita University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

We performed this experimental study to investigate the mechanism of inferior capsular shift procedure to stabilize the shoulder with multidirectional instability.We used 10 fresh previously-frozen cadaveric shoulders. All the muscles were removed from the shoulder, and the scapula was stabilized to the custom-made shoulder fixator. The position of the humeral head relative to the glenoid was measured using plain roentgenograms. The humerus was loaded inferiorly with 0 kg, 0,5 kg, and 1.0 kg load. The capsular conditions were 1) intact, 2) anteroinferior capsule imbricated using a clamp, 3) posteroinferior capsule imbricated in the same fashion. The Intraarticular pressure was measured using a pressure sensor attached to the catheter filled with saline.The negative value of intraarticular pressure increased with the increase of the load in a linear fashion. This was also observed after imbrication of anterior and posterior capsule. There was no significant difference between the capsular conditions. The position of the humeral head translated less than 5 mm when the Intraarticular pressure was intact regardless of capsular conditions. When the Intraarticular pressure was vented, the humeral head dislocated inferiorly. After the imbrication of anterior and posterior capsule, the humeral head was still inferiorly subluxated.In conclusion, the major stabilizing mechanism of the inferior capsular shift procedure is to maintain the intraarticular pressure by reducing the joint volume.

我们进行了这项实验研究，以探讨下包膜移位手术稳定多向不稳定肩关节的机制。我们使用了10具新鲜的冷冻身体肩关节。所有的肌肉都从肩部移除，肩胛骨固定在定制的肩部固定器上。使用普通X线片测量肱骨头相对于肾盂的位置。分别以0 kg、0.5 kg、1.0 kg的负重向下负重。包膜情况：1)完整，2)前下囊用夹子覆盖，3)后下囊以同样方式覆盖。在注入生理盐水的导管上安装压力传感器测量关节内压力，负值随着负荷的增加呈线性增加。这也是在前囊和后囊覆盖后观察到的。两种包膜状态之间无显著差异。无论包膜情况如何，当关节内压力保持不变时，肱骨头的位置平移不到5 mm。当关节内压力排出时，肱骨头下方脱位。前后囊重叠后，肱骨头仍处于半脱位状态。结论：下囊膜移位的主要稳定机制是通过减小关节体积来维持关节内压力。