scholarly journals Mini-open Repair of the Floating Anterior Inferior Glenohumeral Ligament: Combined Treatment of Bankart and Humeral Avulsion of the Glenohumeral Ligament Lesions

2018 ◽  
Vol 7 (12) ◽  
pp. e1281-e1287 ◽  
Author(s):  
Zachary S. Aman ◽  
Mitchell I. Kennedy ◽  
Anthony Sanchez ◽  
Joseph J. Krob ◽  
Colin P. Murphy ◽  
...  
Keyword(s):  
Open Repair ◽  
Combined Treatment ◽  
Glenohumeral Ligament ◽  
Inferior Glenohumeral Ligament ◽  
Mini Open

scholarly journals Mapping of the Inferior Glenohumeral Ligament for Suture Pullout Strength: A Biomechanical Analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096964
Author(s):  
Sumit Raniga ◽  
Joseph Cadman ◽  
Danè Dabirrahmani ◽  
David Bui ◽  
Richard Appleyard ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Biomechanical Study ◽  
Labral Repair ◽  
Pullout Strength ◽  
Recurrent Instability ◽  
Glenohumeral Ligament ◽  
Time Zero ◽  
Capsular Plication ◽  
Inferior Glenohumeral Ligament ◽  
The Impact

Background: Suture pullout during rehabilitation may result in loss of tension in the inferior glenohumeral ligament (IGHL) and contribute to recurrent instability after capsular plication, performed with or without labral repair. To date, the suture pullout strength in the IGHL is not well-documented. This may contribute to recurrent instability. Purpose/Hypothesis: A cadaveric biomechanical study was designed to investigate the suture pullout strength of sutures in the IGHL. We hypothesized that there would be no significant variability of suture pullout strength between specimens and zones. Additionally, we sought to determine the impact of early mobilization on sutures in the IGHL at time zero. We hypothesized that capsular plication sutures would fail under low load. Study Design: Descriptive laboratory study. Methods: Seven fresh-frozen cadaveric shoulders were dissected to isolate the IGHL complex, which was then divided into 18 zones. Sutures in these zones were attached to a linear actuator, and the resistance to suture pullout was recorded. A suture pullout strength map of the IGHL was constructed. These loads were used to calculate the load applied at the hand that would initiate suture pullout in the IGHL. Results: Mean suture pullout strength for all specimens was 61.6 ± 26.1 N. The maximum load found to cause suture pullout through tissue was found to be low, regardless of zone of the IGHL. Calculations suggest that an external rotation force applied to the hand of only 9.6 N may be sufficient to tear capsular sutures at time zero. Conclusion: This study did not provide clear evidence of desirable locations for fixation in the IGHL. However, given the low magnitude of failure loads, the results suggest the timetable for initiation of range-of-motion exercises should be reconsidered to prevent suture pullout through the IGHL. Clinical Relevance: From this biomechanical study, the magnitude of force required to cause suture pullout through the IGHL is met or surpassed by normal postoperative early range-of-motion protocols.

Development of a Finite Element Model of the Inferior Glenohumeral Ligament of the Glenohumeral Joint

2003 ◽  
Author(s):  
William J. Newman ◽  
Richard E. Debski ◽  
Susan M. Moore ◽  
Jeffrey A. Weiss
Keyword(s):  
Finite Element ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Element Model ◽  
Fe Modeling ◽  
Glenohumeral Ligament ◽  
Subject Specific ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule ◽  
Shoulder Stability

The shoulder is one of the most complex and often injured joints in the human body. The inferior glenohumeral ligament (IGHL), composed of the anterior band (AB), posterior band (PB) and the axillary pouch, has been shown to be an important contributor to anterior shoulder stability (Turkel, 1981). Injuries to the IGHL of the glenohumeral capsule are especially difficult to diagnose and treat effectively. The objective of this research was to develop a methodology for subject-specific finite element (FE) modeling of the ligamentous structures of the glenohumeral joint, specifically the IGHL, and to determine how changes in material properties affect predicted strains in the IGHL at 60° of external rotation. Using the techniques developed in this research, an improved understanding of the contribution of the IGHL to shoulder stability can be acquired.

scholarly journals Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears

Medicine ◽  
2017 ◽  
Vol 96 (11) ◽  
pp. e6322 ◽  
Author(s):  
Jin Liu ◽  
Lin Fan ◽  
Yingbo Zhu ◽  
Haotong Yu ◽  
Tianyang Xu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Open Repair ◽  
Rotator Cuff Tears ◽  
Mini Open

scholarly journals Biomechanical properties of the anterior band of the inferior glenohumeral ligament under stress

2003 ◽  
Vol 11 (2) ◽  
pp. 72-78
Author(s):  
José Atualpa Pinheiro Júnior ◽  
José Alberto Dias Leite ◽  
Francisco Erivan de Abreu Melo ◽  
José de Sá Cavalcante Júnior ◽  
Antônio Cantídio Silva Campos ◽  
...  
Keyword(s):  
Biomechanical Properties ◽  
Force Constants ◽  
Stress Strain ◽  
Hooke’S Law ◽  
Glenohumeral Ligament ◽  
Group I ◽  
Hooke's Law ◽  
Inferior Glenohumeral Ligament ◽  
Group Ii

This paper is aimed at studying the behavior of the band of inferior glenohumeral ligament subjected to uniaxial traction. Twenty ligaments were distributed in two groups: Group I ( ligaments with bony origin and insertion) and Group II ( medial portion of the ligament). Uniaxial traction was applied to all tendons utilizing a traction machine develop in the Department of Physics of UFC. Hooke's Law was used for evaluation of ligament behavior during elastic phase and the Exponential stress-strain Law, for rigidity phase. All ligaments had the same behavior, presenting a phase of elasticity , followed by one of rigidity. After evaluation of the elastic phase , applying Hooke's Law, ligaments constants were 10.507 N/mm ( group I ) and 13.80 N/mm ( group II), suffering a straining of 2.83% and 2.84%,respectively, until the ligament became rigid. During rigidity phase, the constants were 511.56% N/mm (group I) and 156.84% N/mm (group II). It is concluded that the ligament submitted to traction suffers a small elongation until becoming rigid along with an important increase in force constants during rigidity phase.

Mini Open Repair

2013 ◽  
pp. 97-97
Author(s):  
Edward Craig ◽  
Zakary Knutson
Keyword(s):  
Open Repair ◽  
Mini Open

Early Postoperative Outcomes Between Arthroscopic and Mini-open Repair for Rotator Cuff Tears

Orthopedics ◽  
2012 ◽  
Vol 35 (9) ◽  
pp. e1347-e1352 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Kwang-Soon Song ◽  
Gu-Hee Jung ◽  
Young-Kuk Lee ◽  
Hong-Kwan Shin
Keyword(s):  
Rotator Cuff ◽  
Open Repair ◽  
Postoperative Outcomes ◽  
Rotator Cuff Tears ◽  
Mini Open

scholarly journals Inferior Glenohumeral Ligament (IGHL) Injuries: A Case Series of Magnetic Resonance (MR) Imaging Findings and Arthroscopic Correlation

2020 ◽  
Vol 13 ◽  
pp. 275-279
Author(s):  
Michael Glass ◽  
Vafa Behzadpour ◽  
Jessica Peterson ◽  
Lauren Clark ◽  
Shelby Bell-Glenn ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Inclusion Criteria ◽  
Glenohumeral Ligament ◽  
Radiology Reports ◽  
Labral Tears ◽  
Tissue Edema ◽  
Cortical Irregularity ◽  
Inferior Glenohumeral Ligament ◽  
Magnetic Resonance Imaging Mri

The inferior glenohumeral ligament (IGHL) complex is commonly assessed by both magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrogram. Our study aimed to compare the accuracy of MR arthrogram compared to MRI using arthroscopic correlation as the gold standard. A retrospective review of cases reporting an IGHL injury was performed. 77 cases met inclusion criteria, while 5 had arthroscopic reports that directly confirmed or refuted the presence of IGHL injury. Two arthroscopic reports confirmed concordant IGHL injuries, while 3 arthroscopic reports mentioned discordant findings compared to MR. Interestingly, all three discordant cases involved MR arthrogram. Findings included soft tissue edema, fraying of the axillary pouch fibers, and cortical irregularity of the humeral neck. Of the two concordant cases, one was diagnosed by MRI, revealing an avulsion of the anterior band, while the second was diagnosed by MR arthrogram showing ill-defined anterior band fibers. Many cases involved rotator cuff or labral tears, which may have been the focus of care for providers, given their importance for shoulder stability. Additionally, a lack of diagnostic confidence in MR reports may have influenced surgeons in the degree to which they assessed the IGHL complex during arthroscopy. In conclusion, radiologists seemed more likely to make note of IGHL injuries when MR arthrograms were performed; meanwhile, all three discordant cases involved MR arthrogram reads. Therefore, additional larger studies are needed with arthroscopic correlation to better elucidate MR findings that confidently suggest injury to the IGHL complex, in order to avoid false positive radiology reports.

Collagen Fiber Alignment and Maximum Principal Strain in the Glenohumeral Capsule Predict Location of Failure During Uniaxial Extension

2011 ◽  
Author(s):  
Kelvin Luu ◽  
Carrie A. Voycheck ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Collagen Fiber ◽  
Glenohumeral Joint ◽  
Uniaxial Extension ◽  
Principal Strain ◽  
Fiber Alignment ◽  
Glenohumeral Ligament ◽  
Maximum Principal Strain ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule ◽  
Collagen Fiber Alignment

The glenohumeral joint is frequently dislocated causing injury to the glenohumeral capsule (axillary pouch (AP), anterior band of the inferior glenohumeral ligament (AB-IGHL), posterior band of the inferior glenohumeral ligament (PB-IGHL), posterior (Post), and anterosuperior region (AS)). [1, 2] The capsule is a passive stabilizer to the glenohumeral joint and primarily functions to resist dislocation during extreme ranges of motion. [3] When unloaded, the capsule consists of randomly oriented collagen fibers, which play a pertinent role in its function to resist loading in multiple directions. [4] The location of failure in only the axillary pouch has been shown to correspond with the highest degree of collagen fiber orientation and maximum principle strain just prior to failure. [4, 5] However, several discrepancies were found when comparing the collagen fiber alignment between the AB-IGHL, AP, and PB-IGHL. [3,6,7] Therefore, the objective was to determine the collagen fiber alignment and maximum principal strain in five regions of the capsule during uniaxial extension to failure and to determine if these parameters could predict the location of tissue failure. Since the capsule functions as a continuous sheet, we hypothesized that maximum principal strain and peak collagen fiber alignment would correspond with the location of tissue failure in all regions of the glenohumeral capsule.

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