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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Does Repair of a Hill-Sachs Defect Increase Stability at the Glenohumeral Joint?
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Does Repair of a Hill-Sachs Defect Increase Stability at the Glenohumeral Joint?

机译：山丘剖面的修复是否会增加Glenohumeral关节的稳定性？

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Background: The effect of osteoallograft repair of a Hill-Sachs lesion and the effect of allograft fit on glenohumeral translations in response to applied force are poorly understood. Purpose: To compare the impact of a 25% Hill-Sachs lesion, a perfect osteoallograft repair (PAR) of a 25% Hill-Sachs lesion, and an “imperfect” osteoallograft repair (IAR) of a 25% Hill-Sachs lesion on glenohumeral translations in response to a compressive load and either an anterior or posterior load in 3 clinically relevant arm positions. Study Design: Controlled laboratory study. Methods: A robotic/universal force-moment sensor testing system was used to apply joint compression (22 N) and an anterior or posterior load (44 N) to cadaveric shoulders (n = 9) with the skin and deltoid removed (intact) at 3 glenohumeral joint positions (abduction/external rotation): 0°/0°, 30°/30°, and 60°/60°. The 25% bony defect state, PAR state, and IAR state were created and the loading protocol was performed. Translational motion was measured in each position for each shoulder state. A nonparametric repeated-measures Friedman test with a Wilcoxon signed-rank post hoc test was performed to compare the biomechanical parameters ( P < .05). Results: Compared with the defect shoulder, the PAR shoulder had significantly less anterior translation with an anterior load in the 0°/0° (15.3 ± 8.2 vs 16.6 ± 9.0 mm, P = .008) and 30°/30° (13.6 ± 7.1 vs 14.2 ± 7.0 mm, P = .021) positions. Compared with IAR, the PAR shoulder had significantly less anterior translation with an anterior load in the 0°/0° (15.3 ± 8.2 vs 16.6 ± 9.0 mm, P = .008) and 30°/30° (13.6 ± 7.1 vs 14.4 ± 7.1 mm, P = .011) positions, and the defect shoulder had significantly less anterior translation with an anterior load in the 30°/30° (14.2 ± 7.0 vs 14.4 ± 7.0 mm, P = .038) position. Conclusion: PAR resulted in the least translational motion at the glenohumeral joint. The defect shoulder had significantly less translational motion at the joint compared with the IAR. An IAR resulted in the most translational motion at the glenohumeral joint. This demonstrates the biomechanical importance of performing an osteoallograft repair in which the allograft closely matches the Hill-Sachs defect and fully restores the preinjury state of the humeral head. Clinical Relevance: This study demonstrates the importance of performing an osteoallograft repair of a Hill-Sachs defect that closely matches the preinjury state and restores normal humeral head anatomy.
机译：背景：山丘损伤的骨煎剂修复的效果及同种异体移植物适应对施加力响应于施加力的胶质移植效果差不多。目的：比较25％Hill-Sachs病变的影响，一个完美的骨灰植物修复（PAR）的25％山丘病变，以及25％山 - 萨赫斯病变的“缺乏”骨质植物植物修复（IAR）响应于压缩负载和3个临床相关的臂位置的胶质形状转换和前部或后载。研究设计：受控实验室研究。方法：使用皮肤和三角形（完整）施加接头压缩（22N）和前载荷（n = 9）的接头压缩（22n）和前载荷（n = 9）施加接头压缩（22n）和前载荷（n = 9） 3个格伦瓦内接头位置（绑架/外部旋转）：0°/ 0°，30°/ 30°和60°/ 60°。创建了25％的骨缺损状态，par状态和IAR状态，并进行了装载方案。在每个肩部状态下在每个位置测量平移运动。进行具有Wilcoxon签名等级后HOC测试的非参数重复测量弗里德曼测试以比较生物力学参数（P <.05）。结果：与缺陷肩相比，PAR肩具有0°/ 0°的前载体的前载均显着较低（15.3±8.2与16.6±9.0 mm，p = .008）和30°/ 30°（1​​3.6 ±7.1 vs 14.2±7.0 mm，p = .021）位置。与IAR相比，PAR肩具有0°/ 0°的前载体的前载平移（15.3±8.2 Vs 16.6±9.0 mm，P = .008）和30°/ 30°（1​​3.6±7.1 Vs 14.4 ±7.1毫米，P = .011）位置，缺陷肩部在30°/ 30°（1​​4.2±7.0 Vs 14.4±7.0mm，P = .038）位置，前载具有明显较低的前载。结论：Glenohumeral关节的平移运动最少。与IAR相比，缺陷肩部在关节上显着较低。 IAR导致Glenohumeral接头中最平移的运动。这证明了进行骨藻藻植物修复的生物力学重要性，其中同种异体移植与山丘缺陷紧密匹配，并完全恢复肱骨头的pre流状态。临床相关性：本研究表明，表演山上缺陷的骨藻属植物修复的重要性，这些缺陷与前肢额状态紧密匹配并恢复正常肱骨头解剖学。

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