In聽vivo 3-dimensional analysis of scapular and glenohumeral kinematics: comparison of symptomatic or asymptomatic shoulders with rotator cuff tears and healthy shoulders

详细信息    查看全文

• 作者：Takehiro Kijima ; MD^a ; ^{kijima0602@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Keisuke Matsuki ; MD ; PhD^b ; Nobuyasu Ochiai ; MD ; PhD^a ; Takeshi Yamaguchi ; MD^a ; Yu Sasaki ; MD^a ; Eiko Hashimoto ; MD^a ; Yasuhito Sasaki ; MD^a ; Hironori Yamazaki ; MD ; PhD^c ; Tomonori Kenmoku ; MD ; PhD^d ; Satoshi Yamaguchi ; MD ; PhD^a ; Yoshitada Masuda ; RT ; PhD^e ; Hideo Umekita ; RT^e ; Scott A. Banks ; PhD^f ; Kazuhisa Takahashi ; MD ; PhD^a
• 关键词：Basic Science Study ; Kinesiology
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：24
• 期：11
• 页码：1817-1826
• 全文大小：1345 K

文摘

Alteration in shoulder kinematics has been suggested as one cause of symptoms in shoulders with rotator cuff tears (RCTs). However, only a few studies comparing symptomatic and asymptomatic RCTs using kinematic analysis have been performed. The purpose of this study was to compare 3-dimensional (3D) scapular and glenohumeral kinematics during scapular-plane abduction among symptomatic RCTs, asymptomatic RCTs, and healthy shoulders.

Methods

This study included 7 healthy shoulders in subjects with a mean age of 62 years, 5 symptomatic RCTs in subjects with a mean age of 70 years, and 7 asymptomatic RCTs in subjects with a mean age of 67 years. All shoulders with RCTs had medium-sized tears (1-3 cm in the coronal plane) that were confirmed with magnetic resonance imaging. Biplane fluoroscopic images during scapular-plane abduction were recorded, and computed tomography–derived 3D bone models were matched with the silhouettes of the bones on the fluoroscopic images using 3D/2-dimensional model-image registration techniques. Angular values of the scapula and glenohumeral kinematics were compared among the 3 groups.

Results

Posterior tilt of the scapula was significantly smaller in the symptomatic RCTs (3.1° ± 1.8°) than in healthy shoulders (10.4° ± 0.8°) (P = .049). The humerus of the symptomatic shoulders was less externally rotated relative to the scapula throughout the activity than the healthy shoulders and asymptomatic RCTs (P = .006 and P = .028 respectively). However, there were no kinematic differences between the asymptomatic RCTs and healthy shoulders.

Conclusion

Kinematic changes in symptomatic RCTs might be associated with development of symptoms. Improvement of these kinematic changes may be a key to successful conservative treatment for symptomatic RCTs.