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首页> 外文期刊>Journal of shoulder and elbow surgery >Effects of combined anterior and posterior plication of the glenohumeral ligament complex for the repair of anterior glenohumeral instability: A biomechanical study
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Effects of combined anterior and posterior plication of the glenohumeral ligament complex for the repair of anterior glenohumeral instability: A biomechanical study

机译：盂肱韧带复合体的前后折叠对修复盂肱前部不稳定性的影响：生物力学研究

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Background: Arthroscopic repair techniques for anterior instability most commonly address only the anterior band of the inferior glenohumeral ligament. This study quantitatively evaluated and compared the combined anterior and posterior arthroscopic plication by repairing both the anterior and posterior bands of the inferior glenohumeral ligament with the anterior arthroscopic plication alone. Materials and methods: Six cadaveric shoulders were tested in 60° of glenohumeral abduction with 22 N of compressive force in the coronal plane for intact, after anterior capsular stretching, after anterior repair, and after posterior arthroscopic repair. Range of motion, glenohumeral translation, and glenohumeral kinematics throughout the rotational range of motion were measured with a MicroScribe 3DLX (Immersion, San Jose, CA, USA). Glenohumeral contact pressure and area were measured with a pressure measurement system (Tekscan Inc, South Boston, MA, USA). Results: Stretching the anterior capsule significantly increased external rotation and anterior translation (P <.05). After anterior plication, external rotation was restored to the intact condition, and anterior translation was significantly decreased compared with stretched condition (P <.05). The combined anterior and posterior plication significantly decreased internal rotation compared with the intact condition. The anterior plication shifted the humeral head posterior in external rotation, whereas the combined anterior and posterior plication shifted the humeral head anterior in internal rotation (P <.05). Both repairs led to a decrease in glenohumeral contact area at 45° external rotation (P <.07). Conclusions: The addition of a posterior plication to anterior plication for anterior instability has no biomechanical advantage over a typical arthroscopic anterior repair for anterior glenohumeral instability.
机译：背景：用于前路不稳的关节镜修复技术通常仅处理下肱骨韧带的前带。这项研究定量地评估和比较了联合的前，后关节镜折叠术，其方法是仅用前关节镜折叠术修复下肱骨韧带的前后带。材料和方法：在尸体肱骨头外展60°时，在冠状平面内施加22 N的压缩力，在前囊拉伸，前路修复和后路关节镜修复后，对六个尸体肩部进行完整测试。使用MicroScribe 3DLX（Immersion，San Jose，CA，USA）测量了整个旋转运动范围内的运动范围，盂肱平移和盂肱运动学。用压力测量系统（Tekscan Inc，美国马萨诸塞州南波士顿）测量鹰嘴猴的接触压力和面积。结果：拉伸前囊明显增加了外旋和前平移（P <.05）。眼前折后，外转恢复到完整状态，与伸直状态相比，前移明显减少（P <.05）。与完整的情况相比，合并的前后褶皱明显减少了内部旋转。前折在外旋中使肱骨头向后移动，而前和后折的组合在内旋中使肱骨头向前移动（P <.05）。两次修复均导致在45°外旋时盂肱接触面积减少（P <.07）。结论：与前折叠相比，在前折叠中增加后折叠比传统的关节镜对前肱骨不稳定的前路修复没有生物力学优势。

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