Effects of combined anterior and posterior plication of the glenohumeral ligament complex for the repair of anterior glenohumeral instability: a biomechanical study

Peltier, Kevin E.; McGarry, Michelle H.; Tibone, James E.; Lee, Thay Q.

doi:10.1016/j.jse.2011.05.005

Cited by 19 publications

(17 citation statements)

References 24 publications

(32 reference statements)

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“…Our results do not demonstrate a significant change in GH motion or subacromial contact pressure following posterior plication. In contrast to the results published by Poitras et al, 39 Mihata et al, 29 and Peltier et al, 38 our study showed a significant decrease in the superior displacement in the sagittal plane at 100° of ABD, while the center of contact and the magnitude of the contact pressure in the subacromial space before and after capsular plication demonstrated no discernible changes.…”

Section: Discussioncontrasting

confidence: 99%

“…Posterior contracture results in a significant loss of internal rotation and abduction (ABD). 10 , 29 , 34 , 38 , 39 Harryman et al 12 demonstrated an increase in anterior and superior glenohumeral (GH) translation during passive forward flexion after tightening of the posterior capsule. Clinically, this problem leads to increased subacromial contact pressure by altering both GH motion and scapulothoracic (ST) motion.…”

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confidence: 99%

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Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

DeAngelis

Hertz²,

Wexler

et al. 2015

Orthopaedic Journal of Sports Medicine

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Background:Shoulder pain is a common problem, with 30% to 50% of the American population affected annually. While the majority of these shoulder problems improve, there is a high rate of recurrence, as 54% of patients experience persistent symptoms 3 years after onset.Purpose:Posterior shoulder tightness has been shown to alter glenohumeral (GH) kinematics. Clinically, posterior shoulder contractures result in a significant loss of internal rotation and abduction (ABD). In this study, the effect of a posterior capsular contracture on GH kinematics was investigated using an intact cadaveric shoulder without violating the joint capsule or the rotator cuff.Study Design:Controlled laboratory study.Methods:Glenohumeral motion, humeral load, and subacromial contact pressure were measured in 6 fresh-frozen left shoulders during passive ABD from 60° to 100° using an automated robotic upper extremity testing system. Baseline values were compared with the experimental condition in which the full thickness of posterior tissues was plicated without decompressing the joint capsule.Results:Posterior soft tissue plication resulted in increased compression between the humeral head and the glenoid (axial load) at 90° of ABD. Throughout ABD, the posterior contracture increased the anterior and superior moment on the humeral head, but it did not change the GH kinematics in this intact model. As a result, there was no increase in the subacromial contact pressure during ABD with posterior plication.Conclusion:In an intact cadaveric shoulder, posterior contracture does not alter GH motion or subacromial contact pressure during passive ABD. By tightening the soft tissue envelope posteriorly, there is an increase in compressive load on the articular cartilage and anterior/superior force on the humeral head. These findings suggest that subacromial impingement in the setting of a posterior soft tissue contracture may result from alterations in scapulothoracic motion, not changes in GH kinematics.Clinical Relevance:This investigation demonstrates that posterior capsular plication increases the axial load on the shoulder joint during ABD. While a significant difference from baseline was observed in the plicated condition, posterior capsular plication did not change GH motion or subacromial contact pressure significantly.

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Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 99%

Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

DeAngelis

Hertz²,

Wexler

et al. 2015

Orthopaedic Journal of Sports Medicine

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show abstract

“…10,23,36,38 However, it has since been determined that anterior-inferior glenoid erosion occurs parallel to the superior-inferior axis of the glenoid during anterior dislocations, 11,16,28,30 and this updated glenoid defect model has been recently studied. 9,39 To evaluate the effectiveness of surgical instability repair with biomechanical studies, emphasis is often placed on a repair technique's ability to restore joint contact stability 6,9,10,12,24 or restore the translational force required for dislocations to the baseline level. 15,18,38,39 Pouliart and Gagey 25 showed that in a cadaveric model, labral resection leads to increased translation of the humeral head on the glenoid.…”

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confidence: 99%

Glenohumeral Contact Pressure With Simulated Anterior Labral and Osseous Defects in Cadaveric Shoulders Before and After Soft Tissue Repair

et al. 2014

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“…(14) Biomechanical studies analysing labral repair reinforced with the IGHL also showed that the labral repairs were secure without compromising the range of motion of the shoulders. (15,16) The findings of these biomechanical studies provided an important platform for the current study, which aimed to optimise the current suturing repair technique.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament via horizontal mattress suturing for traumatic shoulder instability

Lee¹,

Soeharno²,

Chew³

et al. 2013

smedj

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Effects of combined anterior and posterior plication of the glenohumeral ligament complex for the repair of anterior glenohumeral instability: a biomechanical study

Cited by 19 publications

References 24 publications

Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

Glenohumeral Contact Pressure With Simulated Anterior Labral and Osseous Defects in Cadaveric Shoulders Before and After Soft Tissue Repair

Arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament via horizontal mattress suturing for traumatic shoulder instability

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