Analysis in vivo Humeral Rotation using Fluoroscopy and Shape-matching Techniques

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  • TAKAHASHI Yuji
    Showa University School of Nursing and Rehabilitation Science Department of Rehabilitation, Showa University Koto Toyosu Hospital
  • NISHINAKA Naoya
    Research Institute for Sports and Exercise Sciences Showa University
  • MATSUHISA Takayuki
    Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital
  • OZAKI Hisayo
    Showa University School of Nursing and Rehabilitation Science Department of Rehabilitation, Showa University Fujigaoka Hospital
  • CHIBA Shinichi
    Showa University School of Nursing and Rehabilitation Science Department of Rehabilitation, Showa University Hospital
  • TSUTSUI Hiroaki
    Department of Sports Orthopaedic Surgery, Showa University Fujigaoka Rehabilitation Hospital

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  • X 線透視画像および三次元コンピュータモデルを用いた肩関節肩甲骨面外転における肩甲上腕関節の生体内回旋動態解析

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<p>Introduction: External humeral rotation clears the greater tuberosity from beneath the coracoacromial arch and also relaxes the capsular ligamentous constraints, thereby allowing maximum abduction. Kinematics of the glenohumeral joint have been analyzed using various methods. Several studies reported that a loaded condition causes changes in the scapulohumeral rhythm during arm abduction, but few studies reported kinematics of the glenohumeral joint under the loaded condition. The aim of the present study was to determine the influence of loading a 3-kg wrist weight on the external rotation of the humerus during abduction in the scapular plane using a three-dimensional (3D)-to-two-dimensional (2D) model registration technique in vivo.</p><p>Methods: Eighteen dominant side shoulders in 18 subjects (8 males, 10 females; average age 27.9 years, range 23–38 years) were studied. Each participant performed two trials of arm abduction in 0°–120° in the scapular plane while holding a thumbs-up position. Loading with a 3-kg wrist weight was applied in one trial, and no loading was applied in the other trial. 3D motions of the scapula and humerus were determined using model-based 3D-to-2D registration techniques. Motion data were grouped into 5° intervals of shoulder abduction for loaded and unloaded conditions and compared using two-way repeated-measure analysis of variance (p = 0.05) and t-tests.</p><p>Results: The humerus was more than 10.1° externally rotated in the starting position in loaded trials compared with unloaded trials. From the starting position to 85° glenohumeral abduction, the humerus was externally rotated an average of 16.8° in loaded trials and 26.5° in unloaded trials. There was no significant difference in the rotational value between the two groups.</p><p>Discussion: The results of this study revealed that the humerus exhibits the similar external rotation in both loaded and unloaded conditions to clear the greater tuberosity from beneath the coracoacromialarch.</p>

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