背景:关节镜下结节成形术是治疗不可修复的肩袖撕裂的可选技术。然而,缺乏研究研究肩关节外展过程中不可修复的肩袖撕裂和结节成形术的阻力。
目的:肩袖撕裂不可修复,大结节(GT)和肩峰之间的碰撞增加了动态肩关节外展过程中的阻力。假设结节成形术通过减轻撞击来减少这种阻力。
方法:对照实验室研究。
方法:八个尸体肩膀,平均年龄67.75岁(范围,63-72岁),被利用。测试顺序包括完整的肩袖状况,不可修复的肩袖撕裂(IRCT),抛光结节成形术,和假体结节成形术.抛光结节成形术是指使用钻头去除GT上的骨赘的过程,随后对GT进行修整以形成与肱骨头保持连续性的圆形表面。记录Deltoid力和致动器距离。三角形力和致动器距离之间的关系在上升曲线中以图形方式表示。在每个运动周期内的五个点收集数据,对应于20毫米的致动器距离,30毫米,40毫米,50mm,和60毫米。
结果:在完整的肩袖状态下,五个点的阻力为34.25±7.73N,53.75±7.44N,82.50±14.88N,136.25±30.21N,和203.75±30.68N。在IRCT测试周期中,阻力为46.13±7.72N,63.75±10.61N,101.25±9.91N,152.5±21.21N,231.25±40.16N。抛光结节成形术产生32.25±3.54N的阻力,51.25±3.54N,75.00±10.69N,115.00±10.69N,和183.75±25.04N。假体结节成形术显示阻力为29.88±1.55N,49.88±1.36N,73.75±7.44N,112.50±7.07N,和182.50±19.09N。与IRCT相比,两种形式的结节成形术均显着降低了阻力。由于表面光滑,假体结节成形术进一步降低了阻力,尽管与抛光结节成形术相比差异不显着。
结论:在无法修复的肩袖撕裂中,Tuberorotopulation可有效降低动态肩关节外展过程中的阻力。假体结节成形术在减少阻力方面与抛光结节成形术相比没有显着优势。
结论:Tuberomotured有可能减少撞击,随后在动态肩部外展过程中减少阻力,这可能有利于解决假性麻痹等疾病。
BACKGROUND: Arthroscopic tuberoplasty is an optional technique for managing irreparable rotator cuff tears. However, there is a lack of studies investigating the resistance force during shoulder abduction in cases of irreparable rotator cuff tears and tuberoplasty.
OBJECTIVE: In shoulders with irreparable rotator cuff tears, impingement between the greater tuberosity (GT) and acromion increases the resistance force during dynamic shoulder abduction. Tuberoplasty is hypothesized to reduce this resistance force by mitigating impingement.
METHODS: Controlled laboratory study.
METHODS: Eight cadaveric shoulders, with a mean age of 67.75 years (range, 63-72 years), were utilized. The testing sequence included intact rotator cuff condition, irreparable rotator cuff tears (IRCTs), burnishing tuberoplasty, and prosthesis tuberoplasty. Burnishing tuberoplasty refers to the process wherein osteophytes on the GT are removed using a bur, and the GT is subsequently trimmed to create a rounded surface that maintains continuity with the humeral head. Deltoid forces and actuator distances were recorded. The relationship between deltoid forces and actuator distance was graphically represented in an ascending curve. Data were collected at five points within each motion cycle, corresponding to actuator distances of 20 mm, 30 mm, 40 mm, 50 mm, and 60 mm.
RESULTS: In the intact rotator cuff condition, resistance forces at the five points were 34.25 ± 7.73 N, 53.75 ± 7.44 N, 82.50 ± 14.88 N, 136.25 ± 30.21 N, and 203.75 ± 30.68 N. In the IRCT testing cycle, resistance forces were 46.13 ± 7.72 N, 63.75 ± 10.61 N, 101.25 ± 9.91 N, 152.5 ± 21.21 N, and 231.25 ± 40.16 N. Burnishing tuberoplasty resulted in resistance forces of 32.25 ± 3.54 N, 51.25 ± 3.54 N, 75.00 ± 10.69 N, 115.00 ± 10.69 N, and 183.75 ± 25.04 N. Prosthesis tuberoplasty showed resistance forces of 29.88 ± 1.55 N, 49.88 ± 1.36 N, 73.75 ± 7.44 N, 112.50 ± 7.07 N, and 182.50 ± 19.09 N. Both forms of tuberoplasty significantly reduced resistance force compared to IRCTs. Prosthesis tuberoplasty further decreased resistance force due to a smooth surface, although the difference was not significant compared to burnishing tuberoplasty.
CONCLUSIONS: Tuberoplasty effectively reduces resistance force during dynamic shoulder abduction in irreparable rotator cuff tears. Prosthesis tuberoplasty does not offer a significant advantage over burnishing tuberoplasty in reducing resistance force.
CONCLUSIONS: Tuberoplasty has the potential to decrease impingement, subsequently reducing resistance force during dynamic shoulder abduction, which may be beneficial in addressing conditions like pseudoparalysis.