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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2011

01.10.2011 | Shoulder

Increased glenohumeral translation and biceps load after SLAP lesions with potential influence on glenohumeral chondral lesions: a biomechanical study on human cadavers

verfasst von: T. Patzer, P. Habermeyer, C. Hurschler, E. Bobrowitsch, J. R. Paletta, S. Fuchs-Winkelmann, M. D. Schofer

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2011

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Abstract

Purpose

The aim of the study was to evaluate the stabilizing function of the long head of biceps tendon (LHB) and its tension, both without and with the presence of SLAP lesion to analyze a potentially occurring humeral chondral print of LHB with consecutive glenohumeral chondral lesions in SLAP lesions.

Methods

Testings were performed on 21 fresh frozen human cadaver shoulders with intact shoulder girdle by a 5 axis industrial robot with a force/moment sensor and 20 N joint compression, 50 N force in anterior, posterior, anterosuperior, and anteroinferior direction, and 0°, 30°, 60° of abduction. LHB was connected over a force measuring sensor with 5 N and 25 N preload. A type IIC SLAP lesion was created arthroscopically.

Results

A significant increase in anterior and anteroinferior translation was evaluated, whereas the LHB tension increased significantly in at most anterior and anterosuperior direction. The highest increase in translation and LHB tension after SLAP lesion was measured in anterior translation in at most 60° of abduction.
The glenohumeral translation was significantly higher in SLAP lesions without LHB tenotomy than after isolated LHB tenotomy.

Conclusions

SLAP lesions lead to increased glenohumeral translation and concurrently LHB tension and load in at most anterior direction. The increased anterior glenohumeral instability and the increased LHB load pressing on the humeral head might cause glenohumeral chondral lesions with a typical chondral print-like lesion on the humeral head underneath the LHB.
Literatur
1.
Zurück zum Zitat Alexander S, Southgate D, Hill A, Wallace A, Bull A (2008) The role of the biceps tendon in passive translation of the gleno-humeraljoint. SECEC/ESSSE annual conference, Brugge, Belgium, p O44 Alexander S, Southgate D, Hill A, Wallace A, Bull A (2008) The role of the biceps tendon in passive translation of the gleno-humeraljoint. SECEC/ESSSE annual conference, Brugge, Belgium, p O44
2.
Zurück zum Zitat Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13:337–341PubMedCrossRef Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13:337–341PubMedCrossRef
3.
Zurück zum Zitat Bassett RW, Browne AO, Morrey BF, An KN (1990) Glenohumeral muscle force and moment mechanics in a position of shoulder instability. J Biomech 23:405–415PubMedCrossRef Bassett RW, Browne AO, Morrey BF, An KN (1990) Glenohumeral muscle force and moment mechanics in a position of shoulder instability. J Biomech 23:405–415PubMedCrossRef
4.
Zurück zum Zitat Burkart A, Debski R, Musahl V, McMahon P, Woo SL (2003) Biomechanical tests for type II SLAP lesions of the shoulder joint before and after arthroscopic repair. Orthopade 32:600–607PubMedCrossRef Burkart A, Debski R, Musahl V, McMahon P, Woo SL (2003) Biomechanical tests for type II SLAP lesions of the shoulder joint before and after arthroscopic repair. Orthopade 32:600–607PubMedCrossRef
5.
Zurück zum Zitat Burkart A, Debski RE, Musahl V, McMahon PJ (2003) Glenohumeral translations are only partially restored after repair of a simulated type II superior labral lesion. Am J Sports Med 31:56–63PubMed Burkart A, Debski RE, Musahl V, McMahon PJ (2003) Glenohumeral translations are only partially restored after repair of a simulated type II superior labral lesion. Am J Sports Med 31:56–63PubMed
6.
Zurück zum Zitat Burkhart SS, Lo IKY, Brady PC (2006) A cowboy′s guide to advanced shoulder arthroscopy. Lippincott Williams & Wilkins, Philadelphia, pp 65–67 Burkhart SS, Lo IKY, Brady PC (2006) A cowboy′s guide to advanced shoulder arthroscopy. Lippincott Williams & Wilkins, Philadelphia, pp 65–67
7.
Zurück zum Zitat Byram IR, Dunn WR, Kuhn JE (2011) Humeral head abrasion: an association with failed superior labrum anterior posterior repairs. J Shoulder Elbow Surg 20:92–97PubMedCrossRef Byram IR, Dunn WR, Kuhn JE (2011) Humeral head abrasion: an association with failed superior labrum anterior posterior repairs. J Shoulder Elbow Surg 20:92–97PubMedCrossRef
8.
Zurück zum Zitat Castagna A, Mouhsine E, Conti M, Vinci E, Borroni M, Giardella A et al (2007) Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc 15:645–648PubMedCrossRef Castagna A, Mouhsine E, Conti M, Vinci E, Borroni M, Giardella A et al (2007) Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc 15:645–648PubMedCrossRef
9.
Zurück zum Zitat Cooper DE, Arnoczky SP, O’Brien SJ, Warren RF, DiCarlo E, Allen AA (1992) Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 74:46–52PubMed Cooper DE, Arnoczky SP, O’Brien SJ, Warren RF, DiCarlo E, Allen AA (1992) Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 74:46–52PubMed
10.
Zurück zum Zitat Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 9:483–490PubMedCrossRef Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 9:483–490PubMedCrossRef
11.
Zurück zum Zitat Habermeyer P, Magosch P, Pritsch M, Scheibel MT, Lichtenberg S (2004) Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg 13:5–12PubMedCrossRef Habermeyer P, Magosch P, Pritsch M, Scheibel MT, Lichtenberg S (2004) Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg 13:5–12PubMedCrossRef
12.
Zurück zum Zitat Huber WP, Putz RV (1997) Periarticular fiber system of the shoulder joint. Arthroscopy 13:680–691PubMedCrossRef Huber WP, Putz RV (1997) Periarticular fiber system of the shoulder joint. Arthroscopy 13:680–691PubMedCrossRef
13.
Zurück zum Zitat Hurschler C, Wulker N, Windhagen H, Hellmers N, Plumhoff P (2004) Evaluation of the lag sign tests for external rotator function of the shoulder. J Shoulder Elbow Surg 13:298–304PubMedCrossRef Hurschler C, Wulker N, Windhagen H, Hellmers N, Plumhoff P (2004) Evaluation of the lag sign tests for external rotator function of the shoulder. J Shoulder Elbow Surg 13:298–304PubMedCrossRef
14.
Zurück zum Zitat Hurschler C, Wulker N, Windhagen H, Plumhoff P, Hellmers N (2001) Medially based anterior capsular shift of the glenohumeral joint. Passive range of motion and posterior capsular strain. Am J Sports Med 29:346–353PubMed Hurschler C, Wulker N, Windhagen H, Plumhoff P, Hellmers N (2001) Medially based anterior capsular shift of the glenohumeral joint. Passive range of motion and posterior capsular strain. Am J Sports Med 29:346–353PubMed
15.
Zurück zum Zitat Kessler MA, Burkart A, Weiss M, Imhoff AB (2003) SLAP lesions as a cause of posterior instability. Orthopade 32:642–646PubMedCrossRef Kessler MA, Burkart A, Weiss M, Imhoff AB (2003) SLAP lesions as a cause of posterior instability. Orthopade 32:642–646PubMedCrossRef
16.
Zurück zum Zitat Lehmann LJ, Dinter D, Monateseri S, Scharf HP, Weckbach S (2009) Osteoathritis after SLAP Lesion? Clinical and arthro-MRI evaluation after arthroscopic SLAP refixation. Sportverletz Sportschaden 23:155–160PubMedCrossRef Lehmann LJ, Dinter D, Monateseri S, Scharf HP, Weckbach S (2009) Osteoathritis after SLAP Lesion? Clinical and arthro-MRI evaluation after arthroscopic SLAP refixation. Sportverletz Sportschaden 23:155–160PubMedCrossRef
17.
Zurück zum Zitat Lichtenberg S, Magosch P, Habermeyer P (2003) Superior labrum-biceps anchor complex. Orthopade 32:616–626PubMedCrossRef Lichtenberg S, Magosch P, Habermeyer P (2003) Superior labrum-biceps anchor complex. Orthopade 32:616–626PubMedCrossRef
18.
Zurück zum Zitat Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23:93–98PubMedCrossRef Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23:93–98PubMedCrossRef
19.
Zurück zum Zitat McMahon PJ, Burkart A, Musahl V, Debski RE (2004) Glenohumeral translations are increased after a type II superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg 13:39–44PubMedCrossRef McMahon PJ, Burkart A, Musahl V, Debski RE (2004) Glenohumeral translations are increased after a type II superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg 13:39–44PubMedCrossRef
20.
Zurück zum Zitat Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565PubMedCrossRef Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565PubMedCrossRef
21.
Zurück zum Zitat Pagnani MJ, Deng XH, Warren RF, Torzilli PA, Altchek DW (1995) Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg Am 77:1003–1010PubMed Pagnani MJ, Deng XH, Warren RF, Torzilli PA, Altchek DW (1995) Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg Am 77:1003–1010PubMed
22.
Zurück zum Zitat Pagnani MJ, Deng XH, Warren RF, Torzilli PA, O’Brien SJ (1996) Role of the long head of the biceps brachii in glenohumeral stability: a biomechanical study in cadavera. J Shoulder Elbow Surg 5:255–262PubMedCrossRef Pagnani MJ, Deng XH, Warren RF, Torzilli PA, O’Brien SJ (1996) Role of the long head of the biceps brachii in glenohumeral stability: a biomechanical study in cadavera. J Shoulder Elbow Surg 5:255–262PubMedCrossRef
23.
Zurück zum Zitat Patzer T, Kircher J, Lichtenberg S, Magosch P, Habermeyer P (2009) Is there an assocation of SLAP- and biceps-pulley lesions? A prospective clinical study. SECEC/ESSSE Annual Conference. Madrid, Spain Patzer T, Kircher J, Lichtenberg S, Magosch P, Habermeyer P (2009) Is there an assocation of SLAP- and biceps-pulley lesions? A prospective clinical study. SECEC/ESSSE Annual Conference. Madrid, Spain
24.
Zurück zum Zitat Patzer T, Lichtenberg S, Kircher J, Magosch P, Habermeyer P (2010) Influence of SLAP lesions on chondral lesions of the glenohumeral joint. Knee Surg Sports Traumatol Arthrosc 18:982–987 Patzer T, Lichtenberg S, Kircher J, Magosch P, Habermeyer P (2010) Influence of SLAP lesions on chondral lesions of the glenohumeral joint. Knee Surg Sports Traumatol Arthrosc 18:982–987
25.
Zurück zum Zitat Putz R (2002) Topographie und funktionelle Anatomie des Schultergelenks. In: Habermeyer P (ed) Schulterchirurgie. Elsevier, Munich, pp 8–10 Putz R (2002) Topographie und funktionelle Anatomie des Schultergelenks. In: Habermeyer P (ed) Schulterchirurgie. Elsevier, Munich, pp 8–10
26.
Zurück zum Zitat Rodosky MW, Harner CD, Fu FH (1994) The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 22:121–130PubMedCrossRef Rodosky MW, Harner CD, Fu FH (1994) The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 22:121–130PubMedCrossRef
27.
Zurück zum Zitat Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8:644–654PubMedCrossRef Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8:644–654PubMedCrossRef
28.
Zurück zum Zitat Slatis P, Aalto K (1979) Medial dislocation of the tendon of the long head of the biceps brachii. Acta Orthop Scand 50:73–77PubMedCrossRef Slatis P, Aalto K (1979) Medial dislocation of the tendon of the long head of the biceps brachii. Acta Orthop Scand 50:73–77PubMedCrossRef
29.
Zurück zum Zitat Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279PubMedCrossRef Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279PubMedCrossRef
30.
Zurück zum Zitat Walch G, Nove-Josserand L, Boileau P, Levigne C (1998) Subluxations and dislocations of the tendon of the long head of the biceps. J Shoulder Elbow Surg 7:100–108PubMedCrossRef Walch G, Nove-Josserand L, Boileau P, Levigne C (1998) Subluxations and dislocations of the tendon of the long head of the biceps. J Shoulder Elbow Surg 7:100–108PubMedCrossRef
31.
Zurück zum Zitat Walch G, Nove-Josserand L, Levigne C, Renaud E (1994) Tears of the supraspinatus tendon associated with “hidden” lesions of the rotator interval. J Shoulder Elbow Surg 3:353–360CrossRef Walch G, Nove-Josserand L, Levigne C, Renaud E (1994) Tears of the supraspinatus tendon associated with “hidden” lesions of the rotator interval. J Shoulder Elbow Surg 3:353–360CrossRef
32.
Zurück zum Zitat Warner JJ, Bowen MK, Deng X, Torzilli PA, Warren RF (1999) Effect of joint compression on inferior stability of the glenohumeral joint. J Shoulder Elbow Surg 8:31–36PubMedCrossRef Warner JJ, Bowen MK, Deng X, Torzilli PA, Warren RF (1999) Effect of joint compression on inferior stability of the glenohumeral joint. J Shoulder Elbow Surg 8:31–36PubMedCrossRef
33.
Zurück zum Zitat Warner JJ, McMahon PJ (1995) The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am 77:366–372PubMed Warner JJ, McMahon PJ (1995) The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am 77:366–372PubMed
34.
Zurück zum Zitat Wellmann M, Petersen W, Zantop T, Herbort M, Kobbe P, Raschke MJ et al (2009) Open shoulder repair of osseous glenoid defects: biomechanical effectiveness of the Latarjet procedure versus a contoured structural bone graft. Am J Sports Med 37:87–94PubMedCrossRef Wellmann M, Petersen W, Zantop T, Herbort M, Kobbe P, Raschke MJ et al (2009) Open shoulder repair of osseous glenoid defects: biomechanical effectiveness of the Latarjet procedure versus a contoured structural bone graft. Am J Sports Med 37:87–94PubMedCrossRef
35.
Zurück zum Zitat Werner A, Mueller T, Boehm D, Gohlke F (2000) The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med 28:28–31PubMed Werner A, Mueller T, Boehm D, Gohlke F (2000) The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med 28:28–31PubMed
36.
Zurück zum Zitat Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129PubMedCrossRef Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129PubMedCrossRef
Metadaten
Titel
Increased glenohumeral translation and biceps load after SLAP lesions with potential influence on glenohumeral chondral lesions: a biomechanical study on human cadavers
verfasst von
T. Patzer
P. Habermeyer
C. Hurschler
E. Bobrowitsch
J. R. Paletta
S. Fuchs-Winkelmann
M. D. Schofer
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1423-2

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