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Biomechanics and Joint Replacement of the Shoulder and Elbow
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Mark Falworth, Prakash Jayakumar, Simon Lambert
The glenoid labrum is a fibrocartilaginous ridge-shaped structure that increases GHJ congruency, humeral head coverage and contact surface area by deepening the glenoid fossa. It provides 20% of stability to the shoulder. The combined depth of the labrum–glenoid concavity is 9 mm in the superior–inferior axis and 5 mm in the anteroposterior (AP) axis. The labrum increases glenoid depth by 50%, acting as a type of ‘chuck-block’ preventing abnormal translation. It provides an attachment for glenohumeral ligaments and the long head of biceps superiorly. Superiorly, it is triangular in cross-section, meniscal in appearance and relatively mobile. Inferiorly it is rounded in cross-section and more firmly attached. This limits translation of the GHJ. The weakest parts of the capsule and labral complex are anteroinferior and posterosuperior, which are the classic zones of injury in Bankart lesions and superior labrum anterior and posterior (SLAP) tears, respectively.
Arthroscopic HAGL and RHAGL repair
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Stephen Thon, Felix H. Savoie, Michael J. O'Brien
The glenohumeral ligaments provide the attachment of the glenoid to the humerus via the glenoid labrum. The combination of the labrum and capsular ligaments acts to deepen the socket of the glenoid cavity and provide increased stability to the shoulder girdle. The IGHL complex is made of three discrete sections: the anterior band, the posterior band, and the axillary pouch.14–16 It acts as the primary restraint to anterior, posterior, and inferior glenohumeral translation when the shoulder is in 45°–90° of abduction.14,15 The combination of the three creates a suspensory complex to the inferior portion of the glenohumeral joint, providing increased shoulder stability to anterior and inferior translation. The primary action of the IGHL varies with arm position. In 90° of abduction and external rotation, the anterior band provides the primary restraint to shoulder subluxation, whereas the posterior band provides primary restraint with the arm positioned in flexion and internal rotation.11,15
Shoulder girdle and proximal humerus
Published in Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou, Orthopaedic Trauma, 2014
Prakash Jayakumar, Livio Di Mascio
Glenoid labrum – the labrum is a cartilaginous ring forming a tight perimeter on the glenoid rim. It deepens the fossa, thereby providing an attachment for synovial-capsuloligamentous structures and a constraint to humeral head translation. Negative intra-articular pressure – a vacuum-suction effect is exerted on the humeral head within the glenoid fossa. Glenohumeral and coracohumeral ligaments – the superior (SGHL), inferior (IGHL) and middle (MGHL) glenohumeral ligaments are contiguous with the joint capsule. The main restraint against anterior translation in abduction and external rotation is provided by the IGHL. The main restraint against posterior translation is provided by the SGHL, coracohumeral ligament and posterior portion of the IGHL.
Longitudinal assessments of strength and dynamic balance from pre-injury baseline to 3 and 4 months after labrum repairs in collegiate athletes
Published in Physiotherapy Theory and Practice, 2022
Ling Li, Brenna K. McGuinness, Jacob S. Layer, Yu Song, Megan A. Jensen, Boyi Dai
The glenoid labrum is a fibrous rim that surrounds the glenoid cavity to stabilize the glenohumeral joint. Certain labrum injuries may require surgical repairs for specific populations (Dodson and Altchek, 2009). In the general population, the superior labrum from anterior to posterior (SLAP) repairs represent approximately 9.4% of total shoulder surgeries (Weber, Martin, Seiler, and Harrast, 2012). In National Collegiate Athletics Association (NCAA) athletes, SLAP tears and other non-SLAP labrum tears are the two upper extremity injuries mostly requiring surgical treatment (Gil, Goodman, DeFroda, and Owens, 2018). SLAP tears comprise over 17% of shoulder surgeries, while non-SLAP labrum tears are a portion of surgical treatment to shoulder instability that makes up more than 60% of shoulder surgeries (Gil, Goodman, DeFroda, and Owens, 2018).
Shoulder and elbow injuries in NCAA football players, 2009–2010 through 2013–2014
Published in The Physician and Sportsmedicine, 2019
Avi D. Goodman, Jeremy E. Raducha, Steven F. DeFroda, Joseph A. Gil, Brett D. Owens
From the 2009–2010 to 2013–2014 academic years, NCAA football players sustained 1,187 shoulder and elbow injuries in 899,225 AEs for an incidence of 13.20/10,000 AEs (95% CI 12.45–13.95/10,000 AEs). The most common injuries were acromioclavicular (AC) sprain (partial or complete, 29.9%, 3.95/10,000 AEs, Table 1), anterior shoulder subluxation (9.0%, 1.19/10,000 AEs), and shoulder contusion (9.0%, 1.19/10,000 AEs). When considered together, shoulder instability injuries (anterior and posterior subluxation and dislocation, nonsuperior labrum anterior posterior glenoid labrum tears and multidirectional instability) comprised 23.5% of all injuries (incidence 3.10/10,000 AEs).
Development of a New Model of Humeral Hemiarthroplasty in Rats
Published in Journal of Investigative Surgery, 2023
Efi Kazum, Eran Maman, Zachary T. Sharfman, Reut Wengier, Osnat Sher, Amal Khoury, Ofir Chechik, Oleg Dolkart
The glenohumeral joint is a highly mobile joint stabilized by both active and passive structures, including the rotator cuff muscles, the glenohumeral ligament and the glenoid labrum [1]. Complex fracture of the proximal humerus pose a challenge to the orthopedic surgeons, and may be treated in a conservative and operative manner including open reduction and internal fixation, total and partial shoulder replacement [2].