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      EVALUATION OF SCAPULAR DYSKINESIA IN PATIENTS THAT UNDERWENT A LATARJET PROCEDURE Translated title: AVALIAÇÃO DA DISCINESIA ESCAPULAR EM PACIENTES SUBMETIDOS À CIRURGIA DE LATARJET

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          ABSTRACT

          Objective:

          To quantitatively assess the scapular movement of patients who underwent Latarjet surgery and to identify if they present scapular dyskinesia (SD), as well as correlate with the clinic state and the elevation degree of the shoulder.

          Methods:

          A cross-sectional study was carried out at the Movement Analysis Laboratory (LAM), at the Institute of Physical Activity and Sport Sciences, that quantitatively evaluated, using spherical retroreflective markers, the scapular movements of the control group (10 volunteers) and 22 patients (23 operated shoulders) that had been submitted to Latarjet surgery, between 2011 and 2016, with at least one year postoperative. The results of the control group were used as a parameter of normality and compared to those of the operated group. Posterior inclination, superior rotation, and medial rotation of the scapula were evaluated at angles of 60°, 90°, and 120° of elevation, both in ascending and descending phases. The statistical analysis used was the multivariate variance (MANOVA), comparing the right and left sides of the control group and, subsequently, the control group with the postoperative group (p = 0.05 in all tests).

          Results:

          When comparing the mean of the results of the quantitative evaluation of the control group with the operated group, no statistically significant differences were found between the two groups and between the dominant and non-dominant sides of the control group.

          Conclusion:

          Latarjet surgery does not cause SD, although there are alterations in some plane of the scapular movements in the ascending and/or descending phase. Level of Evidence III, Retrospective Comparative Study.

          RESUMO

          Objetivo:

          Avaliar, de forma quantitativa, o movimento escapular dos pacientes submetidos à cirurgia de Latarjet e identificar se apresentam discinesia escapular (DE). Além disso, correlacionar com a clínica e com o grau de elevação do ombro.

          Método:

          Estudo transversal realizado no Laboratório de Análise do Movimento (LAM), no Instituto de Ciências da Atividade Física e Esporte que avaliou de forma quantitativa, utilizando marcadores retro-refletivos esféricos, os movimentos escapulares do grupo controle (10 voluntários) e 22 pacientes (23 ombros operados), submetidos à cirurgia de Latarjet, entre os anos de 2011 e 2016, com pelo menos um ano de pós-operatório. Foram utilizados os resultados do grupo controle como parâmetro de normalidade e posteriormente comparados aos do grupo de pacientes operados. Avaliadas a inclinação posterior, rotação superior e rotação medial das escápulas nos ângulos de 60°, 90° e 120° de elevação, tanto na fase ascendente quanto na descendente. A análise estatística utilizada foi a multivariada da variância (MANOVA) comparando os lados direito e esquerdo do grupo controle e posteriormente o grupo controle com o grupo pós-operatório (p = 0,05 em todos os testes).

          Resultados:

          Ao compararmos a média dos resultados da avaliação quantitativa do grupo controle com o grupo dos operados, não foram evidenciadas diferenças estatisticamente significativas entre os dois grupos, assim como os lados dominante e o não dominante do grupo controle.

          Conclusão:

          A cirurgia de Latarjet não causa DE, apesar de haver alterações em algum plano dos movimentos escapulares na fase ascendente e/ou descendente. Nível de Evidência III, Estudo Retrospectivo Comparativo.

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          Most cited references31

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          ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: shoulder, elbow, wrist and hand.

          In this communication, the Standardization and Terminology Committee (STC) of the International Society of Biomechanics proposes a definition of a joint coordinate system (JCS) for the shoulder, elbow, wrist, and hand. For each joint, a standard for the local axis system in each articulating segment or bone is generated. These axes then standardize the JCS. The STC is publishing these recommendations so as to encourage their use, to stimulate feedback and discussion, and to facilitate further revisions. Adopting these standards will lead to better communication among researchers and clinicians.
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            • Record: found
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            Position and orientation in space of bones during movement: anatomical frame definition and determination

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              The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics.

              PROLOGUE: Several years ago, when we began to question microinstability as the universal cause of the disabled throwing shoulder, we knew that we were questioning a sacrosanct tenet of American sports medicine. However, we were comfortable in our skepticism because we were relying on arthroscopic insights, clinical observations, and biomechanical data, thereby challenging unverified opinion with science. In so doing, we assembled a unified concept of the disabled throwing shoulder that encompassed biomechanics, pathoanatomy, kinetic chain considerations, surgical treatment, and rehabilitation. In developing this unified concept, we rejected much of the conventional wisdom of microinstability-based treatment in favor of more successful techniques (as judged by comparative outcomes) that were based on sound biomechanical concepts that had been scientifically verified. Although we have reported various components of this unified concept previously, we have been urged by many of our colleagues to publish this information together in a single reference for easy access by orthopaedic surgeons who treat overhead athletes. We are grateful to the editors of Arthroscopy for allowing us to present our view of the disabled throwing shoulder. Part I: Pathoanatomy and Biomechanics is presented in this issue. Part II: Evaluation and Treatment of SLAP Lesions in Throwers will be presented in the May-June issue. Part III: The "SICK" Scapula, Scapular Dyskinesis, the Kinetic Chain, and Rehabilitation will be presented in the July-August issue. We hope you find it thought-provoking and compelling.
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                Author and article information

                Journal
                Acta Ortop Bras
                Acta Ortop Bras
                aob
                Acta Ortopedica Brasileira
                ATHA EDITORA
                1413-7852
                1809-4406
                23 May 2022
                2022
                : 30
                : 3
                : e245237
                Affiliations
                [1 ]Faculdade de Ciências Médicas da Santa Casa de São Paulo, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.
                [2 ]Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.
                [3 ]Universidade Cruzeiro do Sul, São Paulo, SP, Brazil.
                [4 ]Universidade Cruzeiro do Sul, Laboratory of Movement Analysis, São Paulo, SP, Brazil.
                Author notes
                Correspondence: Guilherme do Val Sella. Rua Rio de Janeiro, 224, apt. 72, São Paulo, SP, Brazil, 01240010. gvsella@ 123456gmail.com

                All authors declare no potential conflict of interest related to this article.

                AUTHORS’ CONTRIBUTIONS: : Each author contributed individually and significantly to the development of this article. GVS and LAS: data analysis and surgery; GXA: writing and performing surgeries; DSS and AMFB: data collection in the motion laboratory using equipment; ANM: review and intellectual concept of the article, final approval of the manuscript to be published.

                Author information
                http://orcid.org/0000-0002-4742-0366
                http://orcid.org/0000-0002-9385-1941
                http://orcid.org/0000-0003-4725-7172
                http://orcid.org/0000-0003-2475-2314
                http://orcid.org/0000-0002-1148-7681
                http://orcid.org/0000-0002-3121-463X
                Article
                00205
                10.1590/1413-785220223003e245237
                9150869
                db379339-32d6-486e-8573-7f758f99425c

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 03 November 2020
                : 16 March 2021
                Page count
                Figures: 4, Tables: 0, Equations: 0, References: 24
                Categories
                Original Article
                Shoulder and Elbow

                dyskinesias,joint instability,scapula,discinesias,instabilidade articular,escápula

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