Relevance of arm position and muscle activity on three-dimensional glenohumeral translation in patients with traumatic and atraumatic shoulder instability
RMO von Eisenhart-Rothe, A Jäger… - … American journal of …, 2002 - journals.sagepub.com
RMO von Eisenhart-Rothe, A Jäger, KH Englmeier, TJ Vogl, H Graichen
The American journal of sports medicine, 2002•journals.sagepub.comBackground No quantitative data on glenohumeral translation exist allowing one to
distinguish insufficiency of the active or passive stabilizers in different forms of shoulder
instability. Hypothesis To determine whether 1) in traumatic or atraumatic shoulder instability
an increase of glenohumeral translation can be observed in specific relevant arm positions,
2) muscle activity leads to recentering of the humeral head, and 3) there exist differences
between traumatic and atraumatic instability. Study Design Prospective clinical trial …
distinguish insufficiency of the active or passive stabilizers in different forms of shoulder
instability. Hypothesis To determine whether 1) in traumatic or atraumatic shoulder instability
an increase of glenohumeral translation can be observed in specific relevant arm positions,
2) muscle activity leads to recentering of the humeral head, and 3) there exist differences
between traumatic and atraumatic instability. Study Design Prospective clinical trial …
Background
No quantitative data on glenohumeral translation exist allowing one to distinguish insufficiency of the active or passive stabilizers in different forms of shoulder instability.
Hypothesis
To determine whether 1) in traumatic or atraumatic shoulder instability an increase of glenohumeral translation can be observed in specific relevant arm positions, 2) muscle activity leads to recentering of the humeral head, and 3) there exist differences between traumatic and atraumatic instability.
Study Design
Prospective clinical trial.
Methods
In 12 patients with traumatic and 10 patients with atraumatic instability, both shoulders were examined in different arm positions—with and without muscle activity—by using open magnetic resonance imaging and a three-dimensional postprocessing technique.
Results
At 90° of abduction and external rotation, translation (anterior-inferior) was significantly higher in patients with traumatic unstable shoulders compared with their contralateral side (3.6 ± 1.5 versus 0.7 ± 1.6 mm). In patients with atraumatic instability, significantly increased translation (4.7 ± 2.0 mm) was observed, with the direction being nonuniform. Muscle activity led to significant recentering in traumatic but not in atraumatic instability.
Conclusions
In traumatic instability, increased translation was observed only in functionally important arm positions, whereas intact active stabilizers demonstrate sufficient recentering. In atraumatic instability, a decentralized head position was recorded also during muscle activity, suggesting alterations of the active stabilizers.
Clinical Relevance
Clinical Relevance: These data are relevant for optimizing diagnostics and therapeutic strategies.
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