Abstract:
Introduction Acromioplasty is a widely performed procedure for various rotator cuff pathologies with good outcomes and high patient satisfaction. However, few studies have focused on its potential complications. Previous cadaveric studies have demonstrated that a considerable portion of the deltoid muscle is detached from its acromial origin following arthroscopic acromioplasty, but the clinical relevance of this muscle detachment has not been investigated. The goal of our research was to examine the influence of arthroscopic acromioplasty on abduction strength and to assess whether acromial anatomy plays a role in any potential effect. Methods From a preliminary sample of 87 individuals who were diagnosed with isolated impingement syndrome and underwent arthroscopic acromioplasty, 74 patients who met the inclusion criteria were ultimately included in the study. The patients were divided into two groups according to their acromion morphology: Bigliani type 2 (33 patients) and type 3 (41 patients). The isometric abduction strength of the two groups was measured by a handheld dynamometer (Isobex®; Cursor AG, Berne, Switzerland) at different abduction angles preoperatively and at the first, third, and sixth months following surgery and was statistically compared. Results Both groups showed reduced abduction strength postoperatively; however, the strength of abduction in the Bigliani type 3 group returned to near preoperative values in the third month. Although increased mean abduction strength was recorded at 30° abduction in the sixth month, this difference was not statistically significant (p=0.78). In the Bigliani type 2 group, compared with those in the sixth-month group, the preoperative abduction strength decreased from 8.32 kg to 6.0 kg (p = 0.047), 6.57 kg to 5.15 (p = 0.025), and 6.1 kg to 4.56 kg (p = 0.006) at 30, 60, and 90° abduction, respectively. Conclusions Arthroscopic acromioplasty decreased isometric abduction strength in patients with a Bigliani type 2 acromion. Patients should be counseled about this loss, which might be especially important for professional athletes and heavy manual workers.
摘要:
简介肩峰成形术是一种广泛用于各种肩袖病变的手术,具有良好的预后和高的患者满意度。然而,很少有研究关注其潜在的并发症。先前的尸体研究表明,关节镜肩峰成形术后,三角肌的相当一部分从其肩峰起源脱离,但这种肌肉脱离的临床相关性尚未得到研究。我们研究的目的是检查关节镜肩峰成形术对外展强度的影响,并评估肩峰解剖结构是否在任何潜在影响中起作用。方法从87例诊断为孤立性撞击综合征并接受关节镜肩峰成形术的患者的初步样本中,74名符合纳入标准的患者最终被纳入研究。根据肩峰形态将患者分为两组:Bigliani2型(33例)和3型(41例)。通过手持式测力计(Isobex®;CursorAG,伯尔尼,瑞士)术前和第一次不同的外展角度,第三,和术后6个月进行统计学比较。结果两组患者术后外展强度均降低;Bigliani3型组的外展强度在第3个月恢复到接近术前的值.尽管在第6个月外展30°时记录到平均外展强度增加,这一差异无统计学意义(p=0.78).在Bigliani2型组中,与第六个月组相比,术前外展强度从8.32kg下降到6.0kg(p=0.047),6.57千克至5.15(p=0.025),和6.1公斤到4.56公斤(p=0.006)在30、60和90°外展,分别。结论关节镜下肩峰成形术可降低Bigliani2型肩峰患者的等长外展强度。患者应该被告知这种损失,这对专业运动员和重体力劳动者尤其重要。