GLENO-HUMERAL INTRAARTICULAR VOLUME AND PRESSURE MEASURENTS IN SHOULDER DISORDERS
Journal Title: Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion-IRONS - Year 2014, Vol 6, Issue 6
Abstract
Introduction. Changes in pressure and volume of the joint capsule may play a significant role in the pathogenesis of many diseases of the shoulder. Intra-articular pressure acts as a passive stabilizer of the humeral head, and the plastic of the joint capsule with a reduction in the volume of articular glenohumeral joint is one of the methods for treatment of shoulder joint instability. The measurement of these parameters, so far mainly performed on the body, it is difficult to perform in the operating room. Aim. The aim of the study was to compare the parameters of pressure and volume of the shoulder in its various diseases. Material and methods. Intra-articular volume and pressure were measured in 134 patients during an arthroscopy of the shoulder. The subjects were divided into groups: with the instability of the glenohumeral joint without laxity (SI); with instability of the glenohumeral joint laxity (SI + LAX); damage to the rotator cuff (RCT); carpal impingement (SIS); frozen shoulder syndrome (FS). Intra-articular pressure was measured before arthroscopic surgery. Puncture was performed to the joint with injection needle attached by matting tube which one end was dipped in a bowl with saline. The pressure was evaluated by measuring the sucked water column. The measurement of volume the glenohumeral joint was performed during shoulder arthroscopy. Joint cavity was filled with saline at low pressure of arthroscopic pump. Inlet was closed, and the aspirated fluid was collected with 50ml syringe. The measurement was repeated, and the resulting mean value was recorded in the operation book. Results. The group of patients with glenohumeral joint instability was characterized by the highest average volume of the shoulder and the lowest negative pressure. The smallest volume has been demonstrated in patients with symptoms of frozen shoulder. Patients with RCT, SIS and FS were characterized with the largest negative pressure in relation to the atmospheric pressure. There was no statistically significant correlation between the values of volume and pressure. Conclusion. The volume and pressure parameters of shoulder vary in considered diseases of the shoulder. Patients with glenohumeral joint instability have significantly higher volume and higher pressure in comparison to other groups. Decreased volume of the joint in patients with frozen shoulder directly translates the limited range of motion due to stiffness of the joint capsule. Lack of correlation between the volume and pressure, may indicate a lack of mutual influence of the volume and pressure in the shoulder.
Authors and Affiliations
Przemysław Lubiatowski, Jan Długosz, Jakub Stefaniak, Piotr Ogrodowicz, Marta Ślęzak, Leszek Romanowski
Keywords
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