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The effect of defect orientation and size on glenohumeral instability: a biomechanical analysis

Title
The effect of defect orientation and size on glenohumeral instability: a biomechanical analysis
Authors
Shin, Sang-JinKo, Young WonScott, JonathanMcGarry, Michelle H.Lee, Thay Q.
Ewha Authors
신상진
SCOPUS Author ID
신상진scopus
Issue Date
2016
Journal Title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
ISSN
0942-2056JCR Link1433-7347JCR Link
Citation
vol. 24, no. 2, pp. 533 - 539
Keywords
Anterior shoulder instabilityGlenoid bone lossGlenoid defect sizeGlenoid defect orientationBony restoration procedureShoulder muscle strengtheningRehabilitation
Publisher
SPRINGER
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
The purpose of this study was to determine the relationship between bony stability and percentage of anterior glenoid bone loss and the effect of bone loss orientation. Twelve cadaveric shoulders were studied. Glenoid bone defects were simulated in two different osteotomy angles: 0A degrees and 45A degrees to the superoinferior (SI) axis of the glenoid. The force and displacement required for dislocation were measured under two compressive forces of 40 and 60N. Testing was performed for the intact glenoid and glenoid defects of 2, 4, 6, 8, and 10 mm from the anterior margin. The maximum force for dislocation with the 2-mm glenoid defect was significantly decreased compared with intact glenoid (p = 0.01), and this force also significantly decreased with each increase in defect size (p < 0.05). The dislocation force for 45A degrees osteotomy was significantly higher than that for 0A degrees osteotomy for all defect widths up to 8 mm with 40N compression and 6 mm with 60N compression (p < 0.001). The displacement at dislocation did not significantly decrease until the 8-mm defect with the 45A degrees osteotomy but significantly decreased with the 4-mm defect with the 0A degrees osteotomy. The required force for dislocation with 60N compression was significantly higher than that with 40N compression for all osteotomy sizes and orientations. The decrease in stability even with glenoid bone loss as small as 2 mm or 7.5 % of the glenoid width suggests that bony restoration is recommended whenever any bone loss exists. Bone defects parallel to SI axis may be more susceptible to recurrent instability, and shoulder muscle strengthening exercises may increase glenohumeral compressive force and thus improve glenohumeral stability. Bony restoration is recommended whenever bone loss exists even with small bone fragments particularly those in line with the superior-inferior axis of the glenoid.
DOI
10.1007/s00167-015-3943-7
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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