Shape-matching techniqueを用いた外転運動時の生体内上腕骨頭偏位の検討

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The purpose of this study was to investigate glenohumeral translation in-vivo during active shoulder abduction in the scapular plane. 9 healthy shoulders in 9 subjects were studied. CT scans of each shoulder were acquired and 3D models of the scapula and humerus were created. The subject was positioned in front of a fluoroscope and motions were recorded during active abduction in neutral rotation in the plane of the scapula. 3D motions of the scapula and humerus were determined using model-based 3D-to-2D registration. A custom program was used for the shape-matching procedure to obtain 6 degrees of freedom shoulder kinematics. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the plane of the glenoid. The glenoid center was defined as the mid point of the long axis. Humeral translation was referenced to the glenoid center in the superior/inferior direction. The F-test was used to compare kinematic variability between initial and each positions with a significance set at p=0.05. The humerus moved an average of 1.7mm, from an inferior location to the glenoid center, during arm active abduction. The humeral head was centered within 1mm from the glenoid center above 80° abduction. The variability in glenohumeral translation between shoulders decreased significantly from initial to over 110° arm abduction. Our findings agreed with some authors observations of inferior-to-central translation of the humerus on the glenoid and behavior as a perfectly congruent ball and socket join with dynamic abduction. We assumed that the humeral translation to the center of the glenoid provides maximum joint congruency for optimal shoulder function and joint longevity. We believe 3D fluoroscopic analysis of shoulder kinematics can provide information important for improved understanding of shoulder function and this information will lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.
日本肩関節学会の論文

Shape-matching techniqueを用いた外転運動時の生体内上腕骨頭偏位の検討

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