肩関節の動揺性評価におけるload and shift testの診断的価値

抄録

[Purpose] To clarify the diagnostic value of load and shift test (LST) for the assessment of glenohemeral joint laxity compared with examination under anesthesia (EUA).
[Material and Method] We retrospectively reviewed the healthy-side shoulders of 100 patients (65males,35 females) who underwent surgical treatment of their opposite side. Their mean age was 27.5years. We examined the anterior and posterior laxity at 30° and 90° of abduction, and inferior laxity in neutral rotation with the arm at the side. The anterior or posterior laxity was graded into three degrees (-, +, + +), and the inferior laxity was graded into two degrees (sulcus sign -, +). We detrmined the joint laxity positive when the laxity was graded + or + +. We calculated the sensitivity, the specificity and the accuracy of the LST based on the results of the EUA. In addition, when a joint laxity existed at the anterior and posterior transelation on LST, we assessed the discrimination of the grade of the laxity on LST based on the results of the EUA.
[Results]Sensitivity, specificity and accuracy of LST were as follows: inferior; 50.0%,96.0%,98.0%, anterior at 30°of abduction; 45.0%,96.3%,86.0%, anterior at 90°of abduction; 54.2%,100%,78.0%, posterior at 30°of abduction; 36.4%,92.9%,68.0%, posterior at 90°of abduction; 56.0%,88.9%,71.0%, respectively. The discrimination of the grade of laxity: anterior at 30°of abduction; 100%, anterior at 90°of abduction; 84.6%, posterior at 30° of abduction; 87.5%, posterior at 90°of abduction; 77.4%.
[Conclusion]LST was not sensitive but a specific examination compaired with EUA fbr shoulder joint laxity. Moreover, LST was excellent for the discriminating the gradeof the laxity.