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Increased superior translation following multiple simulated anterior dislocations of the shoulder

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

Abstract

Purpose

Recurrent shoulder dislocations can result in kinematic changes of the glenohumeral joint. The number of prior shoulder dislocations may contribute to increased severity of capsulolabral lesions. The kinematics of the glenohumeral joint following multiple dislocations remain poorly understood. The purpose of this study was to assess the kinematics of the glenohumeral joint during anterior dislocations of the shoulder, and more specifically, altered translational motion following multiple dislocations. The kinematics of the glenohumeral joint were hypothesized to change and correlate with the number of dislocations.

Methods

Eight fresh-frozen cadaveric shoulders were dissected free of all soft tissues except the glenohumeral capsule. Each joint was mounted in a robotic testing system. At 60 degrees of glenohumeral abduction, an internal and external rotational torque (1.1 Nm) were applied to the humerus, and the resulting joint kinematics were recorded. Anterior forces were applied to the humerus to anteriorly dislocate the shoulder and the resulting kinematics were recorded during each dislocation. Following each dislocation, the same rotational torque was applied to the humerus, and the resulting joint kinematics were also recorded. A repeated-measures analysis of variance (ANOVA) was used to compare the kinematics following each dislocation.

Results

During the 7th, 8th, 9th, and 10th dislocations, the humerus significantly translated superiorly compared with the shoulder during the 1st dislocation (p < 0.05). Following the 3rd, 4th, 5th, and 10th dislocations, the humeral head significantly translated superiorly compared with the shoulder following the 1st dislocation in the position of 60 degrees of abduction in response to external rotation torque (p < 0.05).

Conclusion

Multiple anterior shoulder dislocations lead to abnormal translational kinematics and result in increased superior translation of the humerus. This may contribute to pathologic superior extension of capsulolabral injuries. Superior translation of the humerus with overhead motion in the setting of recurrent instability may also place the shoulder at risk for extension of the capsulolabral injuries.

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Data Availability

All relevant data generated or analyzed during this study are included in this published article.

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Acknowledgements

The Albert B. Ferguson Jr. MD, Orthopaedic Fund of the University of Pittsburgh and the University of Pittsburgh Medical Center Department of Orthopaedic Surgery.

Funding

This study was funded by The Albert B. Ferguson Jr. MD, Orthopaedic Fund of the Pittsburgh Foundation Grant and by the Department of Orthopaedic Surgery at the University of Pittsburgh Medical Center.

Author information

Authors and Affiliations

  1. Orthopedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA

    Masahito Yoshida, Tetsuya Takenaga, Calvin K. Chan, Ehab M. Nazzal, Volker Musahl, Richard E. Debski & Albert Lin

  2. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Masahito Yoshida, Tetsuya Takenaga, Ehab M. Nazzal, Volker Musahl, Richard E. Debski & Albert Lin

  3. UPMC Freddie Fu Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA, 15203, USA

    Ehab M. Nazzal, Volker Musahl & Albert Lin

  4. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA

    Richard E. Debski

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  1. Masahito Yoshida
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Correspondence to Albert Lin.

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Ethical approval

CORID No. 131: The Dynamic Shoulder Model of Rotator Cuff and Ligament Function. Committee for Oversight of Research and Clinical Training Involving Decedents at University of Pittsburgh. CORID No. 131.

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Yoshida, M., Takenaga, T., Chan, C.K. et al. Increased superior translation following multiple simulated anterior dislocations of the shoulder. Knee Surg Sports Traumatol Arthrosc 31, 1963–1969 (2023). https://doi.org/10.1007/s00167-022-07257-z

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  • DOI: https://doi.org/10.1007/s00167-022-07257-z

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