DooSup Kim1, HoeJeong Chung2, Chang-Ho Yi3, Yeo-Seung Yoon1, Jongsang Son4,5, Youngho Kim6, Myoung-Gi On1, JaeHyung Yang7. 1. Department of Orthopedic Surgery, Wonju Christian Severance Hospital, Wonju College of Medicine, Yonsei University, Ilsan-ro 20, Wonju-si, Gangwon-do, 220-701, Republic of Korea. 2. Department of Orthopedic Surgery, Wonju Christian Severance Hospital, Wonju College of Medicine, Yonsei University, Ilsan-ro 20, Wonju-si, Gangwon-do, 220-701, Republic of Korea. hjchung29@yonsei.ac.kr. 3. Department of Orthopaedic Surgery, DaeGu Armed Forced Hospital, Daegu, Republic of Korea. 4. Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA. 5. Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA. 6. Department of Biomechanical Engineering, Yonsei University, Seoul, Republic of Korea. 7. Department of Orthopaedic Surgery, Gangdong Yonsei Hospital, Seoul, Republic of Korea.
Abstract
PURPOSE: Anterior shoulder dislocation is a common injury, but the optimal management of dislocation remains controversial. We hypothesized that reducing the shoulder in externally rotated position would aid the reduction in capsulolabral lesions. Thus, in this study, contact pressure between the capsulolabral lesion and the glenoid in free ALPSA and Bankart lesions was measured using a cadaver model. METHODS: In 10 specimens, the humerus was externally rotated by abduction on the coronal plane to measure the contact pressure between the capsulolabral complex and glenoid in free ALPSA and Bankart lesions using a Tekscan pressure system. Stability of the joint was confirmed using the Vicon motion analysis system. RESULTS: In the normal shoulder joint, the peak pressure between the subscapularis muscle and the anterior capsule according to the location of the glenohumeral joint decreased to 83.4 ± 21.2 kPa in the 0° abduction and -30° external rotation positions and showed a 300.7 ± 42.9 kPa peak value in the 60° abduction and 60° external rotation positions. In both free ALPSA and Bankart lesions, the lowest pressure between the labral lesion and the glenoid was measured at 0° abduction and -30° external rotation, and the highest pressure was recorded at 60° external rotation and 60° abduction. CONCLUSION: The contact pressure between the capsulolabral complex and the glenoid significantly increased when the abduction and external rotation angles were increased. Based on our results, the conservative management in free ALPSA lesions would respond better than Bankart lesions. IRB OR ETHICAL COMMITTEE APPROVAL: YWMR-12-0-038.
PURPOSE: Anterior shoulder dislocation is a common injury, but the optimal management of dislocation remains controversial. We hypothesized that reducing the shoulder in externally rotated position would aid the reduction in capsulolabral lesions. Thus, in this study, contact pressure between the capsulolabral lesion and the glenoid in free ALPSA and Bankart lesions was measured using a cadaver model. METHODS: In 10 specimens, the humerus was externally rotated by abduction on the coronal plane to measure the contact pressure between the capsulolabral complex and glenoid in free ALPSA and Bankart lesions using a Tekscan pressure system. Stability of the joint was confirmed using the Vicon motion analysis system. RESULTS: In the normal shoulder joint, the peak pressure between the subscapularis muscle and the anterior capsule according to the location of the glenohumeral joint decreased to 83.4 ± 21.2 kPa in the 0° abduction and -30° external rotation positions and showed a 300.7 ± 42.9 kPa peak value in the 60° abduction and 60° external rotation positions. In both free ALPSA and Bankart lesions, the lowest pressure between the labral lesion and the glenoid was measured at 0° abduction and -30° external rotation, and the highest pressure was recorded at 60° external rotation and 60° abduction. CONCLUSION: The contact pressure between the capsulolabral complex and the glenoid significantly increased when the abduction and external rotation angles were increased. Based on our results, the conservative management in free ALPSA lesions would respond better than Bankart lesions. IRB OR ETHICAL COMMITTEE APPROVAL: YWMR-12-0-038.
Authors: Patrick Vavken; Patrick Sadoghi; Julia Quidde; Robert Lucas; Ruth Delaney; Andreas M Mueller; Claudio Rosso; Victor Valderrabano Journal: J Shoulder Elbow Surg Date: 2013-09-30 Impact factor: 3.019
Authors: Philippe Poitras; Stephen P Kingwell; Othman Ramadan; Donald L Russell; Hans K Uhthoff; Peter Lapner Journal: J Shoulder Elbow Surg Date: 2009-12-11 Impact factor: 3.019
Authors: C Michael Robinson; Jonathan Howes; Helen Murdoch; Elizabeth Will; Catriona Graham Journal: J Bone Joint Surg Am Date: 2006-11 Impact factor: 5.284