Ellis Benjamin J, Drury Nicholas J, Moore Susan M, McMahon Patrick J, Weiss Jeffrey A, Debski Richard E
Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA.
Comput Methods Biomech Biomed Engin. 2010 Jun;13(3):413-8. doi: 10.1080/10255840903317378.
The objective of this research was to examine the efficacy of evaluating the region of the glenohumeral capsule being tested by clinical exams for shoulder instability using finite element (FE) models of the glenohumeral joint. Specifically, the regions of high capsule strain produced by glenohumeral joint positions commonly used during a clinical exam were identified. Kinematics that simulated a simple translation test with an anterior load at three external rotation angles were applied to a validated, subject-specific FE model of the glenohumeral joint at 60° of abduction. Maximum principal strains on the glenoid side of the inferior glenohumeral ligament (IGHL) were significantly higher than the maximum principal strains on the humeral side, for all three regions of the IGHL at 30° and 60° of external rotation. These regions of localised strain indicate that these joint positions might be used to test the glenoid side of the IGHL during this clinical exam, but are not useful for assessing the humeral side of the IGHL. The use of FE models will facilitate the search for additional joint positions that isolate high strains to other IGHL regions, including the humeral side of the IGHL.
本研究的目的是使用盂肱关节的有限元（FE）模型，检验通过临床检查评估盂肱关节囊受检区域以诊断肩关节不稳的有效性。具体而言，确定了临床检查期间常用的盂肱关节位置所产生的关节囊高应变区域。在60°外展时，将模拟在三个外旋角度下施加前向负荷的简单平移试验的运动学应用于经过验证的、特定个体的盂肱关节FE模型。在30°和60°外旋时，下盂肱韧带（IGHL）盂侧的最大主应变显著高于肱骨侧的最大主应变，IGHL的所有三个区域均如此。这些局部应变区域表明，在该临床检查期间，这些关节位置可能用于测试IGHL的盂侧，但对评估IGHL的肱骨侧无用。有限元模型的使用将有助于寻找其他关节位置，这些位置可将高应变分离到IGHL的其他区域，包括IGHL的肱骨侧。
