反向肩关节置换术中的手术参数可预测术后手到头部运动的运动学特性。

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL Annals of Biomedical Engineering Pub Date : 2024-09-19 DOI:10.1007/s10439-024-03621-x
Ajinkya A Rai, Clarissa M LeVasseur, Gillian E Kane, Maria A Munsch, Christopher J Como, Alexandra S Gabrielli, Jonathan D Hughes, William J Anderst, Albert Lin
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引用次数: 0

摘要

目的:本研究旨在确定反向肩关节置换术(RSA)中可预测术后手到头运动(H2H)运动学的手术参数,并确定运动学与预后之间的关联。我们假设,肱骨后倾和外侧化程度越高,运动学越好;肩胛骨上旋程度越高,预后越好,运动范围(ROM)越大:35名RSA术后患者同意参与。所有手术参数均在手术时记录或在 CT 上测量。参与者在进行 H2H 操作的同时,以每秒 50 张图像的速度同步采集双平面X光片。数字重建的X光片与双平面X光片相匹配,以确定盂肱关节和肩胛骨的运动学特性。计算所有旋转的贡献度、末端位置、峰值角度和 ROM。计算了关节盂和聚乙烯插入物之间的接触路径。对患者报告的结果(PROs)、临床 ROM 和力量进行了测量。多元线性回归确定了预测运动学的手术参数,皮尔逊相关性确定了运动学和结果之间的关联:结果:肱骨后倾越小,峰值外展越大(p = 0.035)。肱骨颈轴角、后倾和盂倾斜预示着后方接触路径的峰值(p = 0.012)。更好的PROs与更优越的接触路径相关(p 结论:肱骨后倾较少可预测运动的峰值(p = 0.035):较少的肱骨后倾预示着 H2H 期间的运动学特性,这与更有利的 PROs 和临床结果相关。
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Surgical Parameters During Reverse Shoulder Arthroplasty Predict Post-Surgical Kinematics During the Hand-to-Head Motion.

Purpose: This study aimed to identify surgical parameters during reverse shoulder arthroplasty (RSA) that predict post-surgical kinematics during the hand-to-head motion (H2H) and to identify associations between kinematics and outcomes. We hypothesized that greater humeral retroversion and lateralization predict kinematics, and that more scapular upward rotation is associated with better PROs and more range of motion (ROM).

Methods: Thirty-five post-RSA patients consented to participate. All surgical parameters were recorded while operating or measured on CT. Participants performed H2H while synchronized biplane radiographs were collected at 50 images/second. Digitally reconstructed radiographs were matched to biplane radiographs to determine glenohumeral and scapular kinematics. For all rotations, the contribution, end position, peak angles, and ROM were calculated. Contact path between the glenosphere and polyethylene insert was calculated. Patient-reported outcomes (PROs), clinical ROM, and strength were measured. Multiple linear regression identified surgical parameters that predicted kinematics, and Pearson correlation identified associations between kinematics and outcomes.

Results: Less humeral retroversion predicted greater peak abduction (p = 0.035). Humeral neck-shaft angle, retroversion, and glenoid tilt predicted the peak posterior contact path (p = 0.012). Better PROs were associated with more superior contact path (p < 0.001), more abduction (p < 0.001), and greater peak scapular upward rotation (p = 0.017). Greater strength was correlated with more peak external rotation (p = 0.035). Greater external rotation at 90º was associated with more abduction (p = 0.008) and upward scapula rotation ROM (p = 0.015) during H2H.

Conclusion: Less humeral retroversion predicted kinematics during H2H that were associated with more favorable PROs and clinical outcomes.

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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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