Effect of joint compression on inferior stability of the glenohumeral joint

To determine the relative importance of negative intraarticular pressure, capsular tension, and joint compression on inferior stability of the glenohumeral joint we studied 17 fresh, normal adult cadaver shoulders using a “3 degrees of freedom” shoulder test apparatus. Translations were measured in intact and vented shoulders while a 50-N superior and inferior directed force was applied to the shoulder. Three different joint compressive loads (22 N, 111 N, 222 N) were applied externally. Tests were performed in 3 positions of humeral abduction in the scapular plane (0°, 45°, 90°) and in 3 positions of rotation (neutral, maximal internal, and maximal external). After tests of the intact and vented shoulder, the glenohumeral ligaments were sectioned and tests were repeated. With minimal joint compression of 22 N, negative intraarticular pressure and capsular tension limited translation of the humeral head on the glenoid. Increasing the joint compressive load to 111 N resulted in a reduction of mean inferior translation from 11.0 mm to 2.0 mm at 0° abduction, from 21.5 mm to 1.4 mm at 45° abduction, and from 4.5 mm to 1.2 mm at 90° abduction. With a compressive load of 111 N, venting the capsule or sectioning of glenohumeral ligaments had no effect on inferior stability. Clinical relevance: Glenohumeral joint compression through muscle contraction provides stability against inferior translation of the humeral head, and this effect is more important than negative intraarticular pressure or ligament tension.