Anterior instability of the glenohumeral joint with humeral avulsion of the glenohumeral ligament

Abstract

The purpose of this study was to compare, with regard to fixation of the implant and femoral bone resorption, two fully porous-coated stems of different stiffnesses in a canine total hip arthroplasty model. A bilateral arthroplasty was carried out with insertion of a titanium-alloy stem (which had stiffness properties comparable with those of the canine femur) on one side and with insertion of a composite stem (which was three to fivefold more flexible than the canine femur) on the contralateral side. Eight femora were evaluated at six months and eight, at eighteen months after the operation, to determine the extent of bone ingrowth, periprosthetic cortical area, intracortical porosity, and bone-remodeling. Despite the markedly greater flexibility of the composite stems, no significant difference could be detected (with the numbers available), with regard to the overall degree of femoral stress-shielding, cortical area, or cortical porosity, between these stems and the stiffer, titanium-alloy stems at either time-period. However, the composite stems had less bone ingrowth and more formation of radiopaque lines than did the titanium-alloy stems. At eighteen months, the values for bone ingrowth were 9.7 +/- 5.38 percent (mean and standard deviation) for the composite stems compared with 28.1 +/- 5.31 percent for the titanium-alloy stems (p = 0.003). Furthermore, the histological sections from the femora containing a composite stem showed radiopaque lines indicative of fibrous ingrowth approximately threefold more often than did those from the femora containing a titanium-alloy stem (p = 0.02).

The effect of scaffold macroporosity on angiogenesis and cell survival in tissue-engineered smooth muscle

“…Porosity of scaffolds used in tissue engineering have long been known to affect angiogenesis and the development of functional tissue including structural tissues such as bone [21,22] and cartilage [23,24], as well as soft tissues such as the urethra [25], liver [26], skin [27,28], muscle [29], vascular structures [30], and soft tissue fillers [31]. In a previous report, we explored the role of pore size in electrospun polycaprolactone scaffolds using lasercut holes of various diameter ranging from 80 to 300 μm while maintaining a 15% macroporosity by area [32].…”

Arthroscopic Findings in Anterior Shoulder Instability

“…The diagnosis of a HAGL lesion has been reported in several studies [47, 58-65]. These studies included 71 patients with HAGL lesions.…”

“…An external rotation force in addition to hyperabduction commonly results in this lesion in contrast to a hyperabduction and impaction force that may produce a Bankart lesion [46]. The incidence of HAGL lesions after a traumatic dislocation has been reported at 39% in patients without a Bankart lesion [47]. A bony HAGL lesion occurs when the glenohumeral ligament is avulsed along with a bone fragment of the humeral head [48].…”

Finite element modelling of the glenohumeral capsule can help assess the tested region during a clinical exam

“…Common injuries resulting from anterior dislocation are detachment of the inferior glenohumeral ligament (IGHL) from the anterior glenoid and labrum (Bankart, 1923, Bankart, 1938) and humeral avulsion of the glenohumeral ligaments (Bokor et al, 1999, Bui-Mansfield et al, 2002, Chhabra et al, 2004, Richards and Burkhart, 2004, Sailer and Imhof, 2004, Schippinger et al, 2001, Warner and Beim, 1997). Physical diagnostic exams are the most crucial step for diagnosis of the location of injury to the capsule (Brenneke et al, 2000, Mallon and Speer, 1995, Matsen, 1991, Pollock and Bigliani, 1993), but the exams are relatively imprecise and the glenohumeral joint positions used for these exams are not standardized between physicians.…”