The effect of humeral avulsion of the glenohumeral ligaments and humeral repair site on joint laxity: A biomechanical study

Dominic F L Southgate*, Desmond J. Bokor, Umile Giuseppe Longo, Andrew L. Wallace, Anthony M J Bull

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    24 Citations (Scopus)

    Abstract

    Purpose: The aims of this cadaveric study were to assess the effect of different sizes of humeral avulsion of the glenohumeral ligament (HAGL) lesions on joint laxity and to investigate any difference between repairs with anchors placed in a juxtachondral position and repairs with anchors placed in the humeral neck. Methods: Glenohumeral specimens were tested on a shoulder laxity testing system with translations applied anteriorly up to 30 N, with the joint in 60° of glenohumeral abduction. Testing was conducted in neutral rotation and under 1-Nm external rotation for 5 specimen states: intact, medium HAGL lesion (4:30 to 5:30 clock-face position), large HAGL lesion (3:30 to 6:30 clock-face position), repair with juxtachondral suture anchors, and repair with humeral neck suture anchors. Results: Significant increases in translation were observed between the intact and large HAGL lesion states for neutral rotation (1.46 mm [SD, 2.33 mm] at 30 N; P =.049) and external rotation (0.81 mm [SD, 0.72 mm] at 30 N; P =.005). Significant reductions in translation were also observed between the large HAGL lesion and humeral neck repair states for neutral rotation (-1.78 mm [SD, 2.23 mm] at 30 N; P =.022) and external rotation (-0.33 mm [SD, 0.37 mm] at 30 N; P =.015). Conclusions: Large HAGL lesions can increase the passive motion of the glenohumeral joint in both neutral and external rotation, although these differences are small and may be difficult to measure clinically. A repair using anchors placed in the humeral neck is more likely to restore the normal restraint to anterior translation than a juxtachondral repair. Clinical Relevance: Medium HAGL lesions are unlikely to show significant increases in joint translation, and repair of large HAGL lesions should be achieved with anchors placed in the humeral neck if possible.

    Original languageEnglish
    Pages (from-to)990-997
    Number of pages8
    JournalArthroscopy - Journal of Arthroscopic and Related Surgery
    Volume29
    Issue number6
    DOIs
    Publication statusPublished - Jun 2013

    Fingerprint Dive into the research topics of 'The effect of humeral avulsion of the glenohumeral ligaments and humeral repair site on joint laxity: A biomechanical study'. Together they form a unique fingerprint.

    Cite this