Location and magnitude of capsular injuries varies following multiple anterior dislocations of the shoulder: Implications for surgical repair
Capsular injuries can occur during multiple shoulder dislocations. The purpose of this study is to evaluate the location and magnitude of glenohumeral capsular injury following multiple dislocations. We hypothesized that the magnitude of capsular injury would increase and the location of peak injury...
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Veröffentlicht in: | Journal of orthopaedic research 2021-03, Vol.39 (3), p.648-656 |
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description | Capsular injuries can occur during multiple shoulder dislocations. The purpose of this study is to evaluate the location and magnitude of glenohumeral capsular injury following multiple dislocations. We hypothesized that the magnitude of capsular injury would increase and the location of peak injury would vary depending on the number of dislocations. Seven fresh‐frozen cadaveric shoulders were used. A 7 × 11 grid of strain markers was affixed to the anteroinferior capsule. Each joint was then mounted to a six degree‐freedom robotic testing system. Marker tracking was performed following 1, 2, 3, 4, 5, and 10 dislocations to determine the nonrecoverable strain as capsular injury. Following each dislocation, the magnitude of the maximum principal strain representing the nonrecoverable strain in the inferior glenohumeral capsule was quantified by comparing the strain marker positions following each dislocation. The peak value of nonrecoverable strain statistically increased with the number of dislocations in five of seven specimens (p = .0007). The capsular location that had the peak value of nonrecoverable strain varied according to the number of dislocations, and from specimen to specimen. The nonrecoverable strain was identified in the posterior capsule and anterior axillary pouch, which increased with the number of dislocations compared to the other regions of the capsule (p = .001–.012) by up to 16%. Clinical significance: While plication of the anterior axillary pouch is important following multiple dislocations, a more extensive anterior capsular shift may be necessary with an increased number of dislocations in addition to a posterior capsular shift when appropriate. |
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The purpose of this study is to evaluate the location and magnitude of glenohumeral capsular injury following multiple dislocations. We hypothesized that the magnitude of capsular injury would increase and the location of peak injury would vary depending on the number of dislocations. Seven fresh‐frozen cadaveric shoulders were used. A 7 × 11 grid of strain markers was affixed to the anteroinferior capsule. Each joint was then mounted to a six degree‐freedom robotic testing system. Marker tracking was performed following 1, 2, 3, 4, 5, and 10 dislocations to determine the nonrecoverable strain as capsular injury. Following each dislocation, the magnitude of the maximum principal strain representing the nonrecoverable strain in the inferior glenohumeral capsule was quantified by comparing the strain marker positions following each dislocation. The peak value of nonrecoverable strain statistically increased with the number of dislocations in five of seven specimens (p = .0007). The capsular location that had the peak value of nonrecoverable strain varied according to the number of dislocations, and from specimen to specimen. The nonrecoverable strain was identified in the posterior capsule and anterior axillary pouch, which increased with the number of dislocations compared to the other regions of the capsule (p = .001–.012) by up to 16%. Clinical significance: While plication of the anterior axillary pouch is important following multiple dislocations, a more extensive anterior capsular shift may be necessary with an increased number of dislocations in addition to a posterior capsular shift when appropriate.</description><identifier>ISSN: 0736-0266</identifier><identifier>EISSN: 1554-527X</identifier><identifier>DOI: 10.1002/jor.24860</identifier><identifier>PMID: 32940940</identifier><language>eng</language><publisher>United States</publisher><subject>dislocation ; Humans ; joint capsule ; plication ; Reinjuries ; shoulder ; Shoulder Dislocation - complications ; Shoulder Joint - injuries</subject><ispartof>Journal of orthopaedic research, 2021-03, Vol.39 (3), p.648-656</ispartof><rights>2020 Orthopaedic Research Society. Published by Wiley Periodicals LLC</rights><rights>2020 Orthopaedic Research Society. 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The purpose of this study is to evaluate the location and magnitude of glenohumeral capsular injury following multiple dislocations. We hypothesized that the magnitude of capsular injury would increase and the location of peak injury would vary depending on the number of dislocations. Seven fresh‐frozen cadaveric shoulders were used. A 7 × 11 grid of strain markers was affixed to the anteroinferior capsule. Each joint was then mounted to a six degree‐freedom robotic testing system. Marker tracking was performed following 1, 2, 3, 4, 5, and 10 dislocations to determine the nonrecoverable strain as capsular injury. Following each dislocation, the magnitude of the maximum principal strain representing the nonrecoverable strain in the inferior glenohumeral capsule was quantified by comparing the strain marker positions following each dislocation. The peak value of nonrecoverable strain statistically increased with the number of dislocations in five of seven specimens (p = .0007). The capsular location that had the peak value of nonrecoverable strain varied according to the number of dislocations, and from specimen to specimen. The nonrecoverable strain was identified in the posterior capsule and anterior axillary pouch, which increased with the number of dislocations compared to the other regions of the capsule (p = .001–.012) by up to 16%. Clinical significance: While plication of the anterior axillary pouch is important following multiple dislocations, a more extensive anterior capsular shift may be necessary with an increased number of dislocations in addition to a posterior capsular shift when appropriate.</description><subject>dislocation</subject><subject>Humans</subject><subject>joint capsule</subject><subject>plication</subject><subject>Reinjuries</subject><subject>shoulder</subject><subject>Shoulder Dislocation - complications</subject><subject>Shoulder Joint - injuries</subject><issn>0736-0266</issn><issn>1554-527X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1KxDAURoMozji68AUkS11UkzRtWncy-MuAIAruSqa5mcmQNjVpFB_Cd7Y6M-6ECx_ce-5ZfAgdU3JOCWEXK-fPGS9ysoPGNMt4kjHxuovGRKR5Qliej9BBCCtCiKCs2EejlJWcDDNGXzNXy964FstW4UYuWtNHBdhpXMsuRCs9Nu0qegMBv8vf0M5a92HaBW6i7U1nYXjuwRvnsTLBbozhR9IvAYeli1aBv8T3TWfN9qoHPES_GBYWe-ik8YdoT0sb4GiTE_Ryc_08vUtmj7f306tZUqc5IYlkAmRJGSsorwHqrIBMKqk5JzktJVWM8LnQogamM62LuaBlKlSegsy5EiqdoNO1t_PuLULoq8aEGqyVLbgYKsZ5WoiiLPmAnq3R2rsQPOiq86aR_rOipPppvxrar37bH9iTjTbOG1B_5LbuAbhYAx_Gwuf_purh8Wmt_AZIHpLt</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Yoshida, Masahito</creator><creator>Takenaga, Tetsuya</creator><creator>Chan, Calvin K.</creator><creator>Musahl, Volker</creator><creator>Debski, Richard E.</creator><creator>Lin, Albert</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4204-3482</orcidid></search><sort><creationdate>202103</creationdate><title>Location and magnitude of capsular injuries varies following multiple anterior dislocations of the shoulder: Implications for surgical repair</title><author>Yoshida, Masahito ; Takenaga, Tetsuya ; Chan, Calvin K. ; Musahl, Volker ; Debski, Richard E. ; Lin, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3600-a27ea9122814ceec58e5adaf440619a1d204b7f7ce2f5ff8b71937d63ea64d7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>dislocation</topic><topic>Humans</topic><topic>joint capsule</topic><topic>plication</topic><topic>Reinjuries</topic><topic>shoulder</topic><topic>Shoulder Dislocation - complications</topic><topic>Shoulder Joint - injuries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshida, Masahito</creatorcontrib><creatorcontrib>Takenaga, Tetsuya</creatorcontrib><creatorcontrib>Chan, Calvin K.</creatorcontrib><creatorcontrib>Musahl, Volker</creatorcontrib><creatorcontrib>Debski, Richard E.</creatorcontrib><creatorcontrib>Lin, Albert</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshida, Masahito</au><au>Takenaga, Tetsuya</au><au>Chan, Calvin K.</au><au>Musahl, Volker</au><au>Debski, Richard E.</au><au>Lin, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Location and magnitude of capsular injuries varies following multiple anterior dislocations of the shoulder: Implications for surgical repair</atitle><jtitle>Journal of orthopaedic research</jtitle><addtitle>J Orthop Res</addtitle><date>2021-03</date><risdate>2021</risdate><volume>39</volume><issue>3</issue><spage>648</spage><epage>656</epage><pages>648-656</pages><issn>0736-0266</issn><eissn>1554-527X</eissn><abstract>Capsular injuries can occur during multiple shoulder dislocations. The purpose of this study is to evaluate the location and magnitude of glenohumeral capsular injury following multiple dislocations. We hypothesized that the magnitude of capsular injury would increase and the location of peak injury would vary depending on the number of dislocations. Seven fresh‐frozen cadaveric shoulders were used. A 7 × 11 grid of strain markers was affixed to the anteroinferior capsule. Each joint was then mounted to a six degree‐freedom robotic testing system. Marker tracking was performed following 1, 2, 3, 4, 5, and 10 dislocations to determine the nonrecoverable strain as capsular injury. Following each dislocation, the magnitude of the maximum principal strain representing the nonrecoverable strain in the inferior glenohumeral capsule was quantified by comparing the strain marker positions following each dislocation. The peak value of nonrecoverable strain statistically increased with the number of dislocations in five of seven specimens (p = .0007). The capsular location that had the peak value of nonrecoverable strain varied according to the number of dislocations, and from specimen to specimen. The nonrecoverable strain was identified in the posterior capsule and anterior axillary pouch, which increased with the number of dislocations compared to the other regions of the capsule (p = .001–.012) by up to 16%. Clinical significance: While plication of the anterior axillary pouch is important following multiple dislocations, a more extensive anterior capsular shift may be necessary with an increased number of dislocations in addition to a posterior capsular shift when appropriate.</abstract><cop>United States</cop><pmid>32940940</pmid><doi>10.1002/jor.24860</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4204-3482</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | dislocation Humans joint capsule plication Reinjuries shoulder Shoulder Dislocation - complications Shoulder Joint - injuries |
title | Location and magnitude of capsular injuries varies following multiple anterior dislocations of the shoulder: Implications for surgical repair |
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