Mechanism of Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder

下囊移位手术治疗肩部多向不稳定性的机制

基本信息

批准号：
12671392
负责人：
ITOI Eiji
金额：
$ 0.58万
依托单位：
Akita University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

We performed this experimental study to investigate the mechanism of inferior capsular shift procedure to stabilize the shoulder with multidirectional instability.We used 10 fresh previously-frozen cadaveric shoulders. All the muscles were removed from the shoulder, and the scapula was stabilized to the custom-made shoulder fixator. The position of the humeral head relative to the glenoid was measured using plain roentgenograms. The humerus was loaded inferiorly with 0 kg, 0,5 kg, and 1.0 kg load. The capsular conditions were 1) intact, 2) anteroinferior capsule imbricated using a clamp, 3) posteroinferior capsule imbricated in the same fashion. The Intraarticular pressure was measured using a pressure sensor attached to the catheter filled with saline.The negative value of intraarticular pressure increased with the increase of the load in a linear fashion. This was also observed after imbrication of anterior and posterior capsule. There was no significant difference between the capsular conditions. The position of the humeral head translated less than 5 mm when the Intraarticular pressure was intact regardless of capsular conditions. When the Intraarticular pressure was vented, the humeral head dislocated inferiorly. After the imbrication of anterior and posterior capsule, the humeral head was still inferiorly subluxated.In conclusion, the major stabilizing mechanism of the inferior capsular shift procedure is to maintain the intraarticular pressure by reducing the joint volume.

我们进行这项实验研究是为了研究下囊移位手术稳定具有多向不稳定性的肩部的机制。我们使用了 10 个新鲜的先前冷冻的尸体肩部。移除肩部的所有肌肉，并将肩胛骨固定在定制的肩部固定器上。使用X线平片测量肱骨头相对于关节盂的位置。肱骨下方承受 0 kg、0.5 kg 和 1.0 kg 的负载。囊状况为：1) 完整，2) 使用夹子将前下囊叠瓦化，3) 以相同方式将后下囊叠瓦化。使用连接到充满盐水的导管上的压力传感器测量关节内压力。关节内压力的负值随着负载的增加以线性方式增加。在前囊和后囊叠瓦后也观察到了这一点。囊膜条件之间没有显着差异。无论关节囊状况如何，当关节内压力完好无损时，肱骨头的位置平移小于 5 mm。当关节内压力排出时，肱骨头向下脱位。前后囊叠瓦后，肱骨头仍处于下半脱位状态。综上所述，下囊移位手术的主要稳定机制是通过减小关节体积来维持关节内压力。