Josephine Olsen Kipp, Emil T Petersen, Thomas Falstie-Jensen, Johanne Frost Teilmann, Anna Zejden, Rikke Jellesen Åberg, Sepp de Raedt, Theis M Thillemann, Maiken Stilling
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Bone volume models were generated from CT scans, marked with anatomical coordinate systems, and aligned with the digitally reconstructed bone projections on the RSA images. The glenohumeral joint (GHJ) kinematics were evaluated in the anteroposterior and superoinferior direction of: the humeral head centre location relative to the glenoid centre; and the humeral head contact point location on the glenoid.</p><p><strong>Results: </strong>During the apprehension test, the centre of the humeral head was 1.0 mm (95% CI 0.0 to 2.0) more inferior on the glenoid for the ASI shoulder compared with the healthy shoulder. Furthermore, the contact point of the ASI shoulder was 1.4 mm (95% CI 0.3 to 2.5) more anterior and 2.0 mm (95% CI 0.8 to 3.1) more inferior on the glenoid compared with the healthy shoulder. The contact point of the ASI shoulder was 1.2 mm (95% CI 0.2 to 2.6) more anterior during the apprehension test compared to the relocation test.</p><p><strong>Conclusion: </strong>The humeral head centre was located more inferior, and the GHJ contact point was located both more anterior and inferior during the apprehension test for the ASI shoulders than the healthy shoulders. Furthermore, the contact point displacement between the apprehension and relocation test revealed increased joint laxity for the ASI shoulder than the healthy shoulders. These results contribute to existing knowledge that ASI shoulders with glenoid bone loss may also suffer from inferior shoulder instability.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"106-B 10","pages":"1133-1140"},"PeriodicalIF":4.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Glenohumeral joint kinematics during apprehension-relocation test in patients with anterior shoulder instability and glenoid bone loss.\",\"authors\":\"Josephine Olsen Kipp, Emil T Petersen, Thomas Falstie-Jensen, Johanne Frost Teilmann, Anna Zejden, Rikke Jellesen Åberg, Sepp de Raedt, Theis M Thillemann, Maiken Stilling\",\"doi\":\"10.1302/0301-620X.106B10.BJJ-2024-0419.R1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>This study aimed to quantify the shoulder kinematics during an apprehension-relocation test in patients with anterior shoulder instability (ASI) and glenoid bone loss using the radiostereometric analysis (RSA) method. Kinematics were compared with the patient's contralateral healthy shoulder.</p><p><strong>Methods: </strong>A total of 20 patients with ASI and > 10% glenoid bone loss and a healthy contralateral shoulder were included. RSA imaging of the patient's shoulders was performed during a repeated apprehension-relocation test. Bone volume models were generated from CT scans, marked with anatomical coordinate systems, and aligned with the digitally reconstructed bone projections on the RSA images. The glenohumeral joint (GHJ) kinematics were evaluated in the anteroposterior and superoinferior direction of: the humeral head centre location relative to the glenoid centre; and the humeral head contact point location on the glenoid.</p><p><strong>Results: </strong>During the apprehension test, the centre of the humeral head was 1.0 mm (95% CI 0.0 to 2.0) more inferior on the glenoid for the ASI shoulder compared with the healthy shoulder. 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引用次数: 0
摘要
目的:本研究旨在采用放射性立体计量分析(RSA)方法,量化肩关节前不稳定(ASI)和盂骨缺失患者在忐忑-定位测试中的肩关节运动学特性。将运动学数据与患者对侧健康肩部进行比较:方法:共纳入了 20 名 ASI 和盂骨缺损大于 10% 的患者以及健康的对侧肩关节。患者肩部的 RSA 成像是在重复忐忑不安-重新定位测试中进行的。根据 CT 扫描生成骨量模型,标上解剖坐标系,并与 RSA 图像上的数字重建骨投影对齐。对盂肱关节(GHJ)运动学进行了评估,评估方向包括:肱骨头中心相对于盂中心的位置;肱骨头在盂上的接触点位置:在抓握测试中,与健康肩部相比,ASI肩部的肱骨头中心在盂体上的位置更靠下1.0毫米(95% CI 0.0至2.0)。此外,与健康肩关节相比,ASI 肩关节的接触点在盂面上比健康肩关节靠前 1.4 毫米(95% CI 0.3 至 2.5),靠后 2.0 毫米(95% CI 0.8 至 3.1)。与重新定位测试相比,ASI 肩膀在擒拿测试中的接触点更靠前 1.2 毫米(95% CI 0.2 至 2.6):结论:与健康肩部相比,ASI肩部的肱骨头中心位于更下方,而GHJ接触点则位于更前方和更下方。此外,与健康肩部相比,ASI 肩部在擒拿测试和重新定位测试之间的接触点位移显示关节松弛度增加。这些结果有助于进一步了解盂骨缺失的 ASI 肩膀也可能存在肩关节下部不稳定的问题。
Glenohumeral joint kinematics during apprehension-relocation test in patients with anterior shoulder instability and glenoid bone loss.
Aims: This study aimed to quantify the shoulder kinematics during an apprehension-relocation test in patients with anterior shoulder instability (ASI) and glenoid bone loss using the radiostereometric analysis (RSA) method. Kinematics were compared with the patient's contralateral healthy shoulder.
Methods: A total of 20 patients with ASI and > 10% glenoid bone loss and a healthy contralateral shoulder were included. RSA imaging of the patient's shoulders was performed during a repeated apprehension-relocation test. Bone volume models were generated from CT scans, marked with anatomical coordinate systems, and aligned with the digitally reconstructed bone projections on the RSA images. The glenohumeral joint (GHJ) kinematics were evaluated in the anteroposterior and superoinferior direction of: the humeral head centre location relative to the glenoid centre; and the humeral head contact point location on the glenoid.
Results: During the apprehension test, the centre of the humeral head was 1.0 mm (95% CI 0.0 to 2.0) more inferior on the glenoid for the ASI shoulder compared with the healthy shoulder. Furthermore, the contact point of the ASI shoulder was 1.4 mm (95% CI 0.3 to 2.5) more anterior and 2.0 mm (95% CI 0.8 to 3.1) more inferior on the glenoid compared with the healthy shoulder. The contact point of the ASI shoulder was 1.2 mm (95% CI 0.2 to 2.6) more anterior during the apprehension test compared to the relocation test.
Conclusion: The humeral head centre was located more inferior, and the GHJ contact point was located both more anterior and inferior during the apprehension test for the ASI shoulders than the healthy shoulders. Furthermore, the contact point displacement between the apprehension and relocation test revealed increased joint laxity for the ASI shoulder than the healthy shoulders. These results contribute to existing knowledge that ASI shoulders with glenoid bone loss may also suffer from inferior shoulder instability.
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