Skip to main content

Advertisement

SpringerLink
Log in

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

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. 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

    Google Scholar 

  2. Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13:337–341

    Article  PubMed  CAS  Google Scholar 

  3. Bassett RW, Browne AO, Morrey BF, An KN (1990) Glenohumeral muscle force and moment mechanics in a position of shoulder instability. J Biomech 23:405–415

    Article  PubMed  CAS  Google Scholar 

  4. 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 32:600–607

    Article  PubMed  CAS  Google Scholar 

  5. 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 31:56–63

    PubMed  Google Scholar 

  6. Burkhart SS, Lo IKY, Brady PC (2006) A cowboy′s guide to advanced shoulder arthroscopy. Lippincott Williams & Wilkins, Philadelphia, pp 65–67

    Google Scholar 

  7. Byram IR, Dunn WR, Kuhn JE (2011) Humeral head abrasion: an association with failed superior labrum anterior posterior repairs. J Shoulder Elbow Surg 20:92–97

    Article  PubMed  Google Scholar 

  8. 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 15:645–648

    Article  PubMed  Google Scholar 

  9. 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 74:46–52

    PubMed  CAS  Google Scholar 

  10. 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 9:483–490

    Article  PubMed  CAS  Google Scholar 

  11. 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 13:5–12

    Article  PubMed  Google Scholar 

  12. Huber WP, Putz RV (1997) Periarticular fiber system of the shoulder joint. Arthroscopy 13:680–691

    Article  PubMed  CAS  Google Scholar 

  13. 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 13:298–304

    Article  PubMed  Google Scholar 

  14. 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 29:346–353

    PubMed  CAS  Google Scholar 

  15. Kessler MA, Burkart A, Weiss M, Imhoff AB (2003) SLAP lesions as a cause of posterior instability. Orthopade 32:642–646

    Article  PubMed  CAS  Google Scholar 

  16. 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 23:155–160

    Article  PubMed  CAS  Google Scholar 

  17. Lichtenberg S, Magosch P, Habermeyer P (2003) Superior labrum-biceps anchor complex. Orthopade 32:616–626

    Article  PubMed  CAS  Google Scholar 

  18. Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23:93–98

    Article  PubMed  CAS  Google Scholar 

  19. 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 13:39–44

    Article  PubMed  Google Scholar 

  20. 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 14:553–565

    Article  PubMed  CAS  Google Scholar 

  21. 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 77:1003–1010

    PubMed  CAS  Google Scholar 

  22. 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 5:255–262

    Article  PubMed  CAS  Google Scholar 

  23. 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. 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

    Google Scholar 

  25. Putz R (2002) Topographie und funktionelle Anatomie des Schultergelenks. In: Habermeyer P (ed) Schulterchirurgie. Elsevier, Munich, pp 8–10

  26. 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 22:121–130

    Article  PubMed  CAS  Google Scholar 

  27. Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8:644–654

    Article  PubMed  CAS  Google Scholar 

  28. Slatis P, Aalto K (1979) Medial dislocation of the tendon of the long head of the biceps brachii. Acta Orthop Scand 50:73–77

    Article  PubMed  CAS  Google Scholar 

  29. Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279

    Article  PubMed  CAS  Google Scholar 

  30. 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 7:100–108

    Article  PubMed  CAS  Google Scholar 

  31. 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 3:353–360

    Article  Google Scholar 

  32. 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 8:31–36

    Article  PubMed  CAS  Google Scholar 

  33. 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 77:366–372

    PubMed  CAS  Google Scholar 

  34. 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 37:87–94

    Article  PubMed  Google Scholar 

  35. 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 28:28–31

    PubMed  CAS  Google Scholar 

  36. Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was financially supported by a research grant of the GOTS (Munich, Germany) and technically supported by Johnson & Johnson Medical DePuy Mitek Inc. (Raynham, MA, USA; Norderstedt, Germany) and Smith & Nephew Endoscopy Inc. (Andover, MA, USA; Hamburg, Germany). We would like to thank Brandon Greene and Dr. Nina Timmesfeld from the University Institute for Medical Biometry and Epidemiology of Marburg, Germany, for the assistance with the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, University Hospital of Duesseldorf, Duesseldorf, Germany

    T. Patzer

  2. Department of Shoulder Elbow Surgery and Sports Traumatology, ATOS Clinic Heidelberg, Heidelberg, Germany

    P. Habermeyer

  3. Department of Orthopaedics, Laboratory of Biomechanics and Biomaterials, Hannover Medical School, Hannover, Germany

    C. Hurschler & E. Bobrowitsch

  4. Department of Orthopaedics and Rheumatology, University Hospital of Marburg, Marburg, Germany

    J. R. Paletta, S. Fuchs-Winkelmann & M. D. Schofer

Authors
  1. T. Patzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Habermeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Hurschler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Bobrowitsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. R. Paletta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Fuchs-Winkelmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. D. Schofer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Patzer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Patzer, T., Habermeyer, P., Hurschler, C. et al. Increased glenohumeral translation and biceps load after SLAP lesions with potential influence on glenohumeral chondral lesions: a biomechanical study on human cadavers. Knee Surg Sports Traumatol Arthrosc 19, 1780–1787 (2011). https://doi.org/10.1007/s00167-011-1423-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1423-2

Keywords

Search

Navigation