Intra-articular pressure-volume relationship in the disordered shoulder joint.

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概要

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• The intra-articular pressure-volume relationship was examined in two groups of patients. The first group consisted of 10 patients with painful shoulder. The second group consisted of 6 patients with a primary anterior dislocation of the shoulder.Under fluoroscopic control a 23-gauge needle was introduced into the antero-inferior part of the glenohumeral joint. The injection of contrast material containing lidocaine was made at a rate of 4ml/min by a infusion pump. The contrast material was infused with the transducer open to the needle via the three-way stopcock and continuous recording was obtained on the pen recorder during the injection phase.In 9 patients with painful shoulder the intraarticular pressure increased gradually at low volumes, reaching a pressure of 15 to 60 millimetres of mercury at a volume of 5 cubic centimetres. The pressure then rose more steeply, approaching 64 to 232 millimetres of mercury at a volume of 15 cubic centimetres. In one case who had a greater limitation of motion with painful shoulder, the intra-articular pressure rose steeply at low volumes, approaching 112 millimetres of mercury at a volume of 5 cubic centimetres. The mean pressure-volume relationship for all 10 patients with painful shoulder showed a curve of sigmoid form.Closed reduction was performed in all 6 shoulders of the second group. Two patients used an immobilization device for 3 weeks, while four patients began to use the shoulder as early and freely as possible. In every patient the same joint was studied on two separate occasions 3 weeks apart after the closed reduction and two pressure-volume curves obtained in each patient were similar regardless of treatment. No correlation was found between joint elastances and types of treatment.There was no complication associated with the recordings.

• 西日本整形・災害外科学会の論文

著者

• 内藤 正俊

  済生会八幡病院整形外科

• 黒木 健文

  済生会八幡病院 整形外科

• 黒木 健文

  済生会八幡病院

• 緒方 公介

  九州大学 整形外科

• 内藤 正俊

  済生会八幡病院

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