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

Yamamoto, Atsushi; Massimini, Daniel F.; DiStefano, James Guido; Higgins, Laurence D.

doi:10.1177/0363546514531905

Cited by 29 publications

(19 citation statements)

References 39 publications

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“…Yamamoto et al. 7 showed that patients with Bankart lesions, as well as those with glenoid bone loss ranging from 10% to 30%, had increased mean contact pressures compared with physiologically normal shoulders. These pressures returned to baseline after instability repair in all groups, except the 30% bone loss group.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Load-Shift Technique for Intraoperative Assessment of Shoulder Translation

DeFroda

Owens

2018

Arthroscopy Techniques

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Shoulder instability represents a spectrum of disease, ranging from subluxation to dislocation. It may present acutely after trauma or chronically as a result of multiple events. Physical examination is a key component in evaluating the degree of instability and laxity present; however, in-office guarding or apprehension may limit the examination. In addition, patient anatomy or operator technique may limit the accuracy and reproducibility of examination maneuvers such as the load-shift test. We propose an arthroscopic modification to the load-shift technique involving direct visualization to assess the direction and degree of shoulder instability. Our technique allows for the examination of a fully relaxed, anesthetized patient, eliminating guarding, and allows for intraoperative documentation of the patient's laxity both before and after surgical stabilization. In addition, this allows for custom titration of adjunctive capsulorrhaphy in arthroscopic stabilization cases.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Load-Shift Technique for Intraoperative Assessment of Shoulder Translation

DeFroda

Owens

2018

Arthroscopy Techniques

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“…The Hill-Sachs lesion should not be confused posterosuperiorly with the bare area at the junction between the footprint of the infraspinatus and the articular cartilage nor posteroinferiorly with the flattened area of the normal humeral neck. On axial images, the Hill-Sachs lesion is typically found at the level of the coracoid process, whereas the neck is far below this level [ 1 35 68 72 77 80 84 85 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 ].…”

Section: What Shouldn’t We Miss In Patients With Recurrent Anterior Dmentioning

confidence: 99%

What can the Radiologist do to Help the Surgeon Manage Shoulder Instability?

Pouliart

Doering

Shahabpour

2016

Journal of the Belgian Society of Radiology

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Imaging of the shoulder forms an important adjunct in clinical decision making in patients with shoulder instability. The typical lesions related with classic anterior and anteroinferior shoulder dislocation are an anteroinferior labral avulsion with or without bony fragment of bone loss – a (bony) Bankart lesion – and a posterolateral humeral head impaction fracture – the Hill-Sachs lesions. These are relatively straightforward to identify on imaging, although normal variants of the inferior labrum and variants of labral damage may cause confusion. Other capsuloligamentous lesions, often associated with less typical types of instability, are much more difficult to identify correctly on imaging, as they occur in the anterosuperior part of the glenohumeral joint with its many normal variants or because they result in more subtle, and therefore easily overlooked, changes in morphology or signal intensity. This paper aims at describing the appearance of the normal and pathologic glenohumeral joint related to shoulder instability. Ample reference will be given as to why identification of abnormalities, whether normal or pathologic, is important to the surgeon facing a treatment decision.

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“…Sensor behaviour in human knee joint One of the first problems that arise when using the Tekscan sensor for intra-articular contact pressure measurements is wrinkling of the sensor [5,7,10,[34][35][36]. As the sensor is made of a dimensionally stable substrate, it can nicely roll around a cylinder but it is difficult to wrap it around a ball shaped surface.…”

Section: 2mentioning

confidence: 99%

“…In addition, broken cells were observed after testing [36]. Apart from the visible sensor wrinkling, the effect of using the sensor between curved surfaces such as the patellofemoral contact is not clear and can probably not be uniquely quantified [5].…”

Section: 3mentioning

confidence: 99%

Use of Tekscan pressure sensors for measuring contact pressures in the human knee joint

Herregodts

Baets

Victor

et al. 2015

SCAD

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Abstract:The Tekscan pressure sensor is a common instrument to quantify in vitro tibiofemoral and patellofemoral contact pressures, which helps to understand the impact of surgical intervention such as total knee arthroplasty (TKA). As a result of the non-linear behavior of the sensor, the conditioning, normalization and calibration of the sensor are critical to achieve correct measurements. In this paper, a literature review is presented that provides insight in the correct use of these sensors, resulting in optimal accuracy. To guarantee the repeatability of the measurements, a secure and correct fixation of the sensor in the joint is required. Using the sensor for intra-articular measurements induces several unintended effects, which potentially lower the accuracy of the measurement. First, the uneven surface can result in wrinkling and destruction of the sensor, in turn leading to measurement results that can be corrupted. Second, the presence of shear forces on the sensor can lead to wear of the sensor and reduction in sensitivity with loss of accuracy as a result. Also the fixation method can worsen the accuracy. In literature, a deterioration of the accuracy from 3% under optimal conditions to errors of more than 50% are reported as a result of the aforementioned effects.

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

Abstract: A critical glenoid defect size exists in which labral repair alone does not restore normal glenohumeral contact pressures. Surgeons should carefully evaluate glenoid bone loss before selecting a surgical treatment for shoulder instability.

Cited by 29 publications

References 39 publications

Arthroscopic Load-Shift Technique for Intraoperative Assessment of Shoulder Translation

Arthroscopic Load-Shift Technique for Intraoperative Assessment of Shoulder Translation

What can the Radiologist do to Help the Surgeon Manage Shoulder Instability?

Use of Tekscan pressure sensors for measuring contact pressures in the human knee joint

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