Function of the Anterior Band of the Inferior Glenohumeral Ligament During the Load and Shift Test

Author(s):  
William J. Newman ◽  
Richard E. Debski ◽  
John C. Gardiner ◽  
Susan M. Moore ◽  
Jeffrey A. Weiss

The anterior band of the inferior glenohumeral ligament (AB-IGHL) plays a crucial role in anterior shoulder stability. This capsulo-ligamentous structure originates on the anterior edge of the glenoid and labrum and inserts on the anterior/lateral edge of the articular surface of the humeral head. AB-IGHL detachment from the anterior glenoid and labrum (Bankart lesion) as well as capsular stretching are frequent injuries for which initial diagnosis is often difficult. The load and shift test is a clinical exam used to assess the magnitude of anterior instability by applying an anterior load to the humeral head with the shaft in 60 degrees of abduction [1]. Information on the magnitudes and distribution of stress and strain can help in the interpretation of motion during the exam as well as assist in localizing instabilities to particular regions of the capsule. The objectives of this study were to examine the stress and strain in the AB-IGHL during the load and shift test using finite element (FE) modeling techniques.


Author(s):  
William J. Newman ◽  
Richard E. Debski ◽  
Susan M. Moore ◽  
Jeffrey A. Weiss

The shoulder is one of the most complex and often injured joints in the human body. The inferior glenohumeral ligament (IGHL), composed of the anterior band (AB), posterior band (PB) and the axillary pouch, has been shown to be an important contributor to anterior shoulder stability (Turkel, 1981). Injuries to the IGHL of the glenohumeral capsule are especially difficult to diagnose and treat effectively. The objective of this research was to develop a methodology for subject-specific finite element (FE) modeling of the ligamentous structures of the glenohumeral joint, specifically the IGHL, and to determine how changes in material properties affect predicted strains in the IGHL at 60° of external rotation. Using the techniques developed in this research, an improved understanding of the contribution of the IGHL to shoulder stability can be acquired.



2005 ◽  
Vol 14 (1) ◽  
pp. S24-S31 ◽  
Author(s):  
Richard E. Debski ◽  
Jeffrey A. Weiss ◽  
William J. Newman ◽  
Susan M. Moore ◽  
Patrick J. McMahon


2021 ◽  
Vol 54 (3) ◽  
pp. 148-154
Author(s):  
Marcelo Novelino Simão ◽  
Maximilian Jokiti Kobayashi ◽  
Matheus de Andrade Hernandes ◽  
Marcello Henrique Nogueira-Barbosa

Abstract Objective: To evaluate the anatomical variations of the attachment of the inferior glenohumeral ligament (IGHL) to the anterior glenoid rim. Materials and Methods: This was a retrospective review of 93 magnetic resonance arthrography examinations of the shoulder. Two radiologists, who were blinded to the patient data and were working independently, read the examinations. Interobserver and intraobserver agreement were evaluated. The pattern of IGHL glenoid attachment and its position on the anterior glenoid rim were recorded. Results: In 50 examinations (53.8%), the glenoid attachment was classified as type I (originating from the labrum), whereas it was classified as type II (originating from the glenoid neck) in 43 (46.2%). The IGHL emerged at the 4 o’clock position in 58 cases (62.4%), at the 3 o’clock position in 14 (15.0%), and at the 5 o’clock position in 21 (22.6%). The rates of interobserver and intraobserver agreement were excellent. Conclusion: Although type I IGHL glenoid attachment is more common, we found a high prevalence of the type II variation. The IGHL emerged between the 3 o’clock and 5 o’clock positions, most commonly at the 4 o’clock position.



2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096964
Author(s):  
Sumit Raniga ◽  
Joseph Cadman ◽  
Danè Dabirrahmani ◽  
David Bui ◽  
Richard Appleyard ◽  
...  

Background: Suture pullout during rehabilitation may result in loss of tension in the inferior glenohumeral ligament (IGHL) and contribute to recurrent instability after capsular plication, performed with or without labral repair. To date, the suture pullout strength in the IGHL is not well-documented. This may contribute to recurrent instability. Purpose/Hypothesis: A cadaveric biomechanical study was designed to investigate the suture pullout strength of sutures in the IGHL. We hypothesized that there would be no significant variability of suture pullout strength between specimens and zones. Additionally, we sought to determine the impact of early mobilization on sutures in the IGHL at time zero. We hypothesized that capsular plication sutures would fail under low load. Study Design: Descriptive laboratory study. Methods: Seven fresh-frozen cadaveric shoulders were dissected to isolate the IGHL complex, which was then divided into 18 zones. Sutures in these zones were attached to a linear actuator, and the resistance to suture pullout was recorded. A suture pullout strength map of the IGHL was constructed. These loads were used to calculate the load applied at the hand that would initiate suture pullout in the IGHL. Results: Mean suture pullout strength for all specimens was 61.6 ± 26.1 N. The maximum load found to cause suture pullout through tissue was found to be low, regardless of zone of the IGHL. Calculations suggest that an external rotation force applied to the hand of only 9.6 N may be sufficient to tear capsular sutures at time zero. Conclusion: This study did not provide clear evidence of desirable locations for fixation in the IGHL. However, given the low magnitude of failure loads, the results suggest the timetable for initiation of range-of-motion exercises should be reconsidered to prevent suture pullout through the IGHL. Clinical Relevance: From this biomechanical study, the magnitude of force required to cause suture pullout through the IGHL is met or surpassed by normal postoperative early range-of-motion protocols.



2018 ◽  
Vol 7 (12) ◽  
pp. e1281-e1287 ◽  
Author(s):  
Zachary S. Aman ◽  
Mitchell I. Kennedy ◽  
Anthony Sanchez ◽  
Joseph J. Krob ◽  
Colin P. Murphy ◽  
...  


2003 ◽  
Vol 11 (2) ◽  
pp. 72-78
Author(s):  
José Atualpa Pinheiro Júnior ◽  
José Alberto Dias Leite ◽  
Francisco Erivan de Abreu Melo ◽  
José de Sá Cavalcante Júnior ◽  
Antônio Cantídio Silva Campos ◽  
...  

This paper is aimed at studying the behavior of the band of inferior glenohumeral ligament subjected to uniaxial traction. Twenty ligaments were distributed in two groups: Group I ( ligaments with bony origin and insertion) and Group II ( medial portion of the ligament). Uniaxial traction was applied to all tendons utilizing a traction machine develop in the Department of Physics of UFC. Hooke's Law was used for evaluation of ligament behavior during elastic phase and the Exponential stress-strain Law, for rigidity phase. All ligaments had the same behavior, presenting a phase of elasticity , followed by one of rigidity. After evaluation of the elastic phase , applying Hooke's Law, ligaments constants were 10.507 N/mm ( group I ) and 13.80 N/mm ( group II), suffering a straining of 2.83% and 2.84%,respectively, until the ligament became rigid. During rigidity phase, the constants were 511.56% N/mm (group I) and 156.84% N/mm (group II). It is concluded that the ligament submitted to traction suffers a small elongation until becoming rigid along with an important increase in force constants during rigidity phase.



2013 ◽  
Vol 805-806 ◽  
pp. 1794-1799
Author(s):  
Zhao Li ◽  
Chen Long Yang ◽  
Yun Xu ◽  
Yue Chao Chen

Based on the Structure and wind load force characteristics of the vehicle mounted extensible mast system, a test method for the wind load simulation of the system was designed. According to the thin wall part structural feature, a method that adding lateral tension at the flanges of the mast was used to simulate wind load. Calculation method of the theoretical wind load force was given, and the transformation formulas between loading force needed and theoretical wind force was put forward, as well the control method of the test based on PID control algorithm was described. Simulation of the force condition under trapezoidal load was given by ANSYS. The results showed that using the load scheme designed, the distribution of stress and strain was almost the same as continuous load, as well as the value and position of the maximum stress and strain.



2020 ◽  
Vol 13 ◽  
pp. 275-279
Author(s):  
Michael Glass ◽  
Vafa Behzadpour ◽  
Jessica Peterson ◽  
Lauren Clark ◽  
Shelby Bell-Glenn ◽  
...  

The inferior glenohumeral ligament (IGHL) complex is commonly assessed by both magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrogram. Our study aimed to compare the accuracy of MR arthrogram compared to MRI using arthroscopic correlation as the gold standard. A retrospective review of cases reporting an IGHL injury was performed. 77 cases met inclusion criteria, while 5 had arthroscopic reports that directly confirmed or refuted the presence of IGHL injury. Two arthroscopic reports confirmed concordant IGHL injuries, while 3 arthroscopic reports mentioned discordant findings compared to MR. Interestingly, all three discordant cases involved MR arthrogram. Findings included soft tissue edema, fraying of the axillary pouch fibers, and cortical irregularity of the humeral neck. Of the two concordant cases, one was diagnosed by MRI, revealing an avulsion of the anterior band, while the second was diagnosed by MR arthrogram showing ill-defined anterior band fibers. Many cases involved rotator cuff or labral tears, which may have been the focus of care for providers, given their importance for shoulder stability. Additionally, a lack of diagnostic confidence in MR reports may have influenced surgeons in the degree to which they assessed the IGHL complex during arthroscopy. In conclusion, radiologists seemed more likely to make note of IGHL injuries when MR arthrograms were performed; meanwhile, all three discordant cases involved MR arthrogram reads. Therefore, additional larger studies are needed with arthroscopic correlation to better elucidate MR findings that confidently suggest injury to the IGHL complex, in order to avoid false positive radiology reports.



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