The moment arms and lines of action of subscapularis after the Latarjet procedure.

Autor: Fox A; School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia., Ernstbrunner L; Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia., Henze J; Department of Orthopaedic Surgery, Barwon Health, Geelong, Victoria, Australia., Page RS; Department of Orthopaedic Surgery, Barwon Health, Geelong, Victoria, Australia.; Barwon Centre for Orthopaedic Research and Education (B-CORE), School of Medicine, Deakin University, Geelong, Australia., Ackland DC; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2024 Jun; Vol. 42 (6), pp. 1159-1169. Date of Electronic Publication: 2024 Jan 18.
DOI: 10.1002/jor.25773
Abstrakt: The Latarjet procedure is an established surgical treatment for recurrent glenohumeral joint instability with glenoid bone loss. Intraoperatively, the conjoint tendon and its attachement on the coracoid bone graft is routed through a split in subscapularis where the graft is fixed to and augments the anteroinferior glenoid. The objective of this in vitro study was to quantify the influence of glenohumeral joint position and conjoint tendon force on the lines of action and moment arms of subscapularis muscle sub-regions after Latarjet surgery. Eight fresh-frozen, entire upper extremities were mounted onto a testing apparatus, and a cable-pulley system was used to apply physiological muscle loading to the major shoulder muscles. The lines of action and moment arms of four subregions of subscapularis (superior, mid-superior, mid-inferior, and inferior) were quantified radiographically with the conjoint tendon unloaded and loaded while the shoulder was in (i) 0° abduction (ii) 90° abduction (iii) 90° abduction and full external rotation (ABER), and (iv) the apprehension position, defined as ABER with 30° horizontal extension. Conjoint tendon loading after Latarjet surgery significantly increased the inferior inclination of the lines of action of the mid-inferior and inferior subregions of subscapularis in the scapular plane in ABER and apprehension positions (p < 0.001), as well as decreased the horizontal flexion moment arm of the inferior subscapularis (p = 0.040). Increased subscapularis inferior inclination may ultimately increase inferior joint shear potential, while smaller horizontal flexion leverage may reduce joint flexion capacity. The findings have implications for Latarjet surgical planning and postoperative rehabilitation prescription.
(© 2024 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)
Databáze: MEDLINE
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