Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation.

Pagnani, Michael J.; Deng, Xiang‐Hua; Warren, Russell F.; Torzilli, Peter A.; Altchek, David W.

doi:10.2106/00004623-199507000-00005

Cited by 241 publications

(126 citation statements)

References 23 publications

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“…The glenoid labrum plays an important role in this process. 38,46,59,60 Perry 40 demonstrated that the depth of the glenoid fossa across its equatorial line is doubled (from 2.5 to 5 mm) by the presence of the labrum. The labrum is a fibrous structure strongly attached around the edge of the glenoid that serves to increase the contact surface area between the glenoid and the humeral head.…”

Section: Normal Anatomy and Biomechanics Of The Glenoid Labrummentioning

confidence: 99%

“…53 However, free nerve endings have been isolated in the fibrocartilagenous tissue of the labrum, the biceps-labrum complex, and the connective tissue surrounding the labrum. 19,53 The glenoid labrum enhances shoulder stability in 4 distinct ways: (1) it produces a ''chock-block'' effect between the glenoid and the humeral head that serves to limit humeral head translation 10,38,57,60 ; (2) it increases the ''concavity-compression'' effect between the humeral head and the glenoid 10,31,38,57,60 ; (3) it contributes to the stabilizing effect of the long head of the biceps anchor 46,57,60 ; and (4) it increases the overall depth of the glenoid fossa. 10,57,60 …”

Section: Normal Anatomy and Biomechanics Of The Glenoid Labrummentioning

confidence: 99%

“…7,25,38,43,46,63 Normal biceps function and glenohumeral stability is dependent on a stable superior labrum and biceps anchor. Pagnani et al 38 found that a complete lesion of the superior portion of the labrum large enough to destabilize the insertion of the biceps was associated with significant increases in anterior-posterior and superior-inferior glenohumeral translation. Reinold et al 43 reported that in a series of 130 overhead athletes with symptomatic hyper laxity undergoing thermal-assisted capsular shrinkage of the glenohumeral joint (TACS), 69% exhibited superior labral degeneration, while 35% had type II SLAP lesions.…”

Section: Pathomechanics Of Slap Lesionsmentioning

confidence: 99%

“…Reinold et al 43 reported that in a series of 130 overhead athletes with symptomatic hyper laxity undergoing thermal-assisted capsular shrinkage of the glenohumeral joint (TACS), 69% exhibited superior labral degeneration, while 35% had type II SLAP lesions. Furthermore, Pagnani et al 38 reported that the presence of a simulated SLAP lesion in 7 cadaveric shoulders resulted in a 6-mm increase in anterior glenohumeral translation. These studies are in agreement with the results of Glousman, 16 who showed increased EMG activity of the biceps brachii in baseball pitchers with anterior instability.…”

Section: Pathomechanics Of Slap Lesionsmentioning

confidence: 99%

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Current Concepts in the Recognition and Treatment of Superior Labral (SLAP) Lesions

Wilk¹,

Reinold²,

Dugas³

et al. 2005

J Orthop Sports Phys Ther

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Pathology of the superior aspect of the glenoid labrum (SLAP lesion) poses a significant challenge to the rehabilitation specialist due to the complex nature and wide variety of etiological factors associated with these lesions. A thorough clinical evaluation and proper identification of the extent of labral injury is important to determine the most appropriate nonoperative and/or surgical management. Postoperative rehabilitation is based on the specific surgical procedure as well as the extent, location, and mechanism of labral pathology and associated lesions. Emphasis is placed on protecting the healing labrum, while gradually restoring range of motion, strength, and dynamic stability of the glenohumeral joint. The purpose of this paper is to provide an overview of the anatomy and pathomechanics of SLAP lesions and review specific clinical examination techniques used to identify these lesions, including 3 newly described tests. Furthermore, a review of the current surgical management and postoperative rehabilitation guidelines is provided. J Orthop Sports Phys Ther 2005;35:273-291.

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Section: Normal Anatomy and Biomechanics Of The Glenoid Labrummentioning

confidence: 99%

Section: Normal Anatomy and Biomechanics Of The Glenoid Labrummentioning

confidence: 99%

Section: Pathomechanics Of Slap Lesionsmentioning

confidence: 99%

Section: Pathomechanics Of Slap Lesionsmentioning

confidence: 99%

See 2 more Smart Citations

Current Concepts in the Recognition and Treatment of Superior Labral (SLAP) Lesions

Wilk¹,

Reinold²,

Dugas³

et al. 2005

J Orthop Sports Phys Ther

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show abstract

“…The humeral head translated with significantly less force when the width of the osseous defect was at least 21 percent of the glenoid length (average width = 6.8 mm) [15]. Elimination of normal negative pressure by the venting of the joint to the atmosphere or simulation of a superior labrum from anterior to posterior (SLAP) lesion by incision of the superior labrum from anterior to posterior was also associated with anterior instability in cadaveric study [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning

McMahon

Chow²,

Sciaroni³

et al. 2003

JRRD

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Abstract-A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning is presented. This model simulates an in vivo mechanism and yields capsulolabral lesions. The scapulae of 14 cadaveric entire upper limbs (82 ± 9 years, mean ± standard deviation) were each rigidly fixed to a custom shoulder-testing device. A pneumatic system was used with pulleys and cables to simulate the rotator cuff and the deltoid muscles (anterior and middle portions). The glenohumeral joint was then positioned in the apprehension position of abduction, external rotation, and horizontal abduction. A 6-degree-of-freedom load cell (Assurance Technologies, Garner, North Carolina) measured the joint reaction force that was then resolved into three orthogonal components of compression force, anteriorly directed force, and superiorly directed force. With the use of a thrust bearing, the humerus was moved along a rail with a servomotor-controlled system at 50 mm/s that resulted in horizontal abduction. Force that developed passively in the pectoralis major muscle was recorded with an independent uniaxial load cell. Each of the glenohumeral joints dislocated anterior-inferior, six with avulsion of the capsulolabrum from the anterior-inferior glenoid bone and eight with capsulolabral stretching. Pectoralis major muscle force as well as the joint reaction force increased with horizontal abduction until dislocation. At dislocation, the magnitude of the pectoralis major muscle force, 609.6 N ± 65.2 N was similar to the compression force, 569.6 N ± 37.8 N. A cadaveric model yielded an anterior dislocation with a mechanism of forcible apprehension positioning when the appropriate shoulder muscles were simulated and a passive pectoralis major muscle was included. Capsulolabral lesions resulted, similar to those observed in vivo.

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Role of the long head of the biceps brachii muscle in axial humeral rotation control

Eshuis

Gast

2011

Clinical Anatomy

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This anatomical and biomechanical study focuses on the specific influence of the long head of biceps brachii muscle in controlling axial humeral rotation. The tendon of the long head of the biceps brachii (biceps tendon) is shown to either facilitate or restrict axial humeral rotation. Its effect on axial humeral rotation is strongly related to firstly the amount of biceps tendon load, secondly glenohumeral scapular plane elevation, and thirdly the rotatory position of the humerus. At 0° glenohumeral elevation, biceps tendon load caused an increase of internal humeral rotation, from 0° at 2.25 N biceps tendon load to 23° at 82.25 N. Under 45° glenohumeral elevation, biceps tendon load can restrict and facilitate as well internal and external axial humeral rotation, increasing the rotatory range of motion. Above 45° glenohumeral elevation biceps tendon load restricts internal and external axial humeral rotation, increasing actively joint stability by increasing torsional rigidity. These findings on the function of the biceps tendon could have consequences for the clinical interpretation. In the elevated arm position, extreme rotation loads the long head of the biceps tendon and may turn out to biceps or bicepslabrum complex injuries.

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Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation.

Cited by 241 publications

References 23 publications

Current Concepts in the Recognition and Treatment of Superior Labral (SLAP) Lesions

Current Concepts in the Recognition and Treatment of Superior Labral (SLAP) Lesions

A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning

Role of the long head of the biceps brachii muscle in axial humeral rotation control

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