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.

Collagen Fiber Alignment and Maximum Principle Strain in the Axillary Pouch Predict Location of Failure During Uniaxial Extension

2010 ◽  
Author(s):  
Carrie A. Voycheck ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Maximum Principle ◽  
Collagen Fiber ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Uniaxial Extension ◽  
Supraspinatus Tendon ◽  
Collagen Fibers ◽  
Fiber Alignment ◽  
Glenohumeral Ligament ◽  
Collagen Fiber Alignment

The glenohumeral joint is frequently dislocated in the anterior direction causing injury to the anteroinferior (axillary pouch, anterior band of the inferior glenohumeral ligament (AB-IGHL)) capsule. [1, 2] When unloaded, the axillary pouch consists of randomly oriented collagen fibers. These fibers play a pertinent role in its function to resist loading in multiple directions during dislocation at the extreme ranges of motion. [3] Maximum principle strain directions in the anteroinferior capsule have been shown to align with the AB-IGHL during increasing external rotation, suggesting that the collagen fibers may become more aligned with loading as well. [4] In addition, at positions of increased external rotation, the peak maximum principle strains in the capsule correspond to the location of a common capsular failure known as the Bankart lesion. [4] Further, an increase in collagen fiber alignment with load in the supraspinatus tendon has been shown in the toe region of the load-elongation curve. [5] Therefore, it was hypothesized that increases in the collagen fiber alignment and maximum principle strain would correlate with the location of tissue failure. The objective of this work was to determine the collagen fiber alignment and maximum principle strain in the axillary pouch during uniaxial extension to failure and to determine if these parameters could predict the location of tissue failure.

A Method for Predicting Collagen Fiber Alignment in the Glenohumeral Capsule During Clinically Relevant Deformations

2012 ◽  
Author(s):  
Carrie A. Rainis ◽  
Rouzbeh Amini ◽  
Richard E. Debski
Keyword(s):  
Collagen Fiber ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Constitutive Models ◽  
Complex Loading ◽  
Anterior Dislocation ◽  
Fiber Alignment ◽  
Glenohumeral Ligament ◽  
Glenohumeral Capsule ◽  
Collagen Fiber Alignment

Injury to the anteroinferior (anterior band of the inferior glenohumeral ligament (AB-IGHL) and axillary pouch) glenohumeral capsule is a common result of anterior dislocation [1]. Validated finite element models of the capsule can be used to address research questions regarding diagnostic and repair techniques targeted to this region of the capsule. However, these models require adequate constitutive models to describe capsule behavior. Structural models have improved predictions of capsule behavior compared to phenomenological models [2] but current experimental techniques used to measure fiber distributions in biologic soft tissues require that the sample be planar and cannot be performed on three-dimensional structures. Although recent work has demonstrated that the fiber kinematics in the capsule do not precisely follow the global tissue deformation [3], the affine assumption is presently the best approximation to provide initial insight into changes in collagen fiber alignment under moderate deformations. The collagen fibers in localized areas of planar samples from the anteroinferior capsule align with the direction of loading [4,5]; however, their behavior may be quite different during the complex loading conditions experienced by the intact capsule. Therefore, the objective of this work was to computationally project planar fiber distribution information to the three-dimensional glenohumeral capsule and use the affine assumption to quantify the change in fiber alignment of the anteroinferior glenohumeral capsule from an inflated reference state to three clinically relevant joint positions.

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.

Mechanical Properties of the Glenohumeral Capsule Change With Simulated Injury

2010 ◽  
Author(s):  
Carrie A. Voycheck ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Glenohumeral Joint ◽  
Tissue Sample ◽  
Biomechanical Properties ◽  
Recurrent Instability ◽  
Glenohumeral Ligament ◽  
Inferior Glenohumeral Ligament ◽  
Normal Stability ◽  
Glenohumeral Capsule ◽  
Anterior Direction ◽  
Repair Techniques

The glenohumeral joint suffers more dislocations than any other joint, most of which occur in the anterior direction. The anterior band of the inferior glenohumeral ligament (AB-IGHL) is the primary restraint to these dislocations and as a result experiences the highest strains during these events. [1] Injuries to the capsule following dislocation include permanent tissue deformation that increases joint mobility and contributes to recurrent instability. [2] This deformation can be quantified by measuring nonrecoverable strain. [3] Simulated injury of the capsule results in permanently elongated tissue and nonrecoverable strain. Current surgical repair techniques are subjective and may not fully address all capsular tissue pathologies resulting from dislocation. Surgeons typically repair the injured capsule by plicating the stretched-out tissue; however, these techniques are inadequate with 23% of patients needing an additional repair. [4] Quantitative data on the changes in the biomechanical properties of the capsule following dislocation may help to predict the amount of capsular tissue to plicate for restoring normal stability. Therefore, the objectives of this study were to quantify changes in stiffness and material properties of the AB-IGHL tissue sample following simulated injury (creation of nonrecoverable strain).

Ligamentous Restraints to External Rotation of the Humerus in the Late-Cocking Phase of Throwing

2000 ◽  
Vol 28 (2) ◽  
pp. 200-205 ◽  
Author(s):  
John E. Kuhn ◽  
Michael J. Bey ◽  
Laura J. Huston ◽  
Ralph B. Blasier ◽  
Louis J. Soslowsky
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Coracoacromial Ligament ◽  
Glenohumeral Ligament ◽  
Coracohumeral Ligament ◽  
Potential Source ◽  
Glenohumeral Ligaments ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule

The late-cocking phase of throwing is characterized by extreme external rotation of the abducted arm; repeated stress in this position is a potential source of glenohumeral joint laxity. To determine the ligamentous restraints for external rotation in this position, 20 cadaver shoulders (mean age, 65 16 years) were dissected, leaving the rotator cuff tendons, coracoacromial ligament, glenohumeral capsule and ligaments, and coracohumeral ligament intact. The combined superior and middle glenohumeral ligaments, anterior band of the inferior glenohumeral ligament, and the entire inferior glenohumeral ligament were marked with sutures during arthroscopy. Specimens were mounted in a testing apparatus to simulate the late-cocking position. Forces of 22 N were applied to each of the rotator cuff tendons. An external rotation torque (0.06 N m/sec to a peak of 3.4 N m) was applied to the humerus of each specimen with the capsule intact and again after a single randomly chosen ligament was cut (N 5 in each group). Cutting the entire inferior glenohumeral ligament resulted in the greatest increase in external rotation (10.2° 4.9°). This was not significantly different from sectioning the coracohumeral ligament (8.6° 7.3°). The anterior band of the inferior glenohumeral ligament (2.7° 1.5°) and the superior and middle glenohumeral ligaments (0.7° 0.3°) were significantly less important in limiting external rotation.

The Effect of Anterior Dislocation on the Mechanical Properties of the Inferior Glenohumeral Ligament

2012 ◽  
Author(s):  
Daniel P. Browe ◽  
Carrie A. Rainis ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Mechanical Properties ◽  
Glenohumeral Joint ◽  
Permanent Deformation ◽  
Recurrent Dislocation ◽  
The Body ◽  
Anterior Dislocation ◽  
Glenohumeral Ligament ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule ◽  
Repair Techniques

The glenohumeral joint is the most frequently dislocated major joint in the body with about 2% of the population dislocating their shoulders between the ages of 18 and 70 [1]. Instability due to permanent deformation of the glenohumeral capsule is commonly associated with dislocation [2]. Current surgical repair techniques for shoulder dislocations typically consist of plication of the glenohumeral capsule, or folding the tissue over on itself, to reduce redundancy in the capsule and restore stability to the shoulder. Up to 25% of patients who undergo surgery for a shoulder dislocation still experience pain, instability, and recurrent dislocation after surgery [3]. It is hypothesized that the mechanical properties of the glenohumeral capsule change in response to dislocation. In addition, the magnitude and location of these changes may have implications for the ideal location and extent of plication. Therefore, the objective of this study was to quantify the mechanical properties of the axillary pouch of the glenohumeral capsule in tension and shear after anterior dislocation.

Preconditioning is Correlated With Altered Collagen Fiber Alignment in Ligament

2011 ◽  
Vol 133 (6) ◽  
Author(s):  
Kyle P. Quinn ◽  
Beth A. Winkelstein
Keyword(s):  
Collagen Fiber ◽  
Polarized Light ◽  
Peak Force ◽  
Principal Strain ◽  
Fiber Direction ◽  
Fiber Alignment ◽  
Tangent Stiffness ◽  
Vector Correlation ◽  
Fiber Organization ◽  
Collagen Fiber Alignment

Although the mechanical phenomena associated with preconditioning are well-established, the underlying mechanisms responsible for this behavior are still not fully understood. Using quantitative polarized light imaging, this study assessed whether preconditioning alters the collagen fiber alignment of ligament tissue, and determined whether changes in fiber organization are associated with the reduced force and stiffness observed during loading. Collagen fiber alignment maps of facet capsular ligaments (n = 8) were generated before and after 30 cycles of cyclic tensile loading, and alignment vectors were correlated between the maps to identify altered fiber organization. The change in peak force and tangent stiffness between the 1st and 30th cycle were determined from the force-displacement response, and the principal strain field of the capsular ligament after preconditioning was calculated from the fiber alignment images. The decreases in peak ligament force and tangent stiffness between the 1st and 30th cycles of preconditioning were significantly correlated (R ≥ 0.976, p < 0.0001) with the change in correlation of fiber alignment vectors between maps. Furthermore, the decrease in ligament force was correlated with a rotation of the average fiber direction toward the direction of loading (R = −0.730; p = 0.0396). Decreases in peak force during loading and changes in fiber alignment after loading were correlated (p ≤ 0.0157) with the average principal strain of the unloaded ligament after preconditioning. Through the use of a vector correlation algorithm, this study quantifies detectable changes to the internal microstructure of soft tissue produced by preconditioning and demonstrates that the reorganization of the capsular ligament’s collagen fiber network, in addition to the viscoelasticity of its components, contribute to how the mechanical properties of the tissue change during its preconditioning.

scholarly journals Quantitative mapping of collagen fiber alignment in thick tissue samples using transmission polarized-light microscopy

2016 ◽  
Vol 21 (7) ◽  
pp. 071111 ◽  
Author(s):  
Dmitry D. Yakovlev ◽  
Marina E. Shvachkina ◽  
Maria M. Sherman ◽  
Andrey V. Spivak ◽  
Alexander B. Pravdin ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Collagen Fiber ◽  
Polarized Light ◽  
Polarized Light Microscopy ◽  
Tissue Samples ◽  
Fiber Alignment ◽  
Quantitative Mapping ◽  
Collagen Fiber Alignment
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