Williams Nicholas R, LeVasseur Matthew R, Mancini Michael R, Obopilwe Elifho, Coyner Katherine J, Arciero Robert A, Mazzocca Augustus D
Farmington, Connecticut, U.S.A.
Department of Orthopedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Feb 24;5(2):e473-e477. doi: 10.1016/j.asmr.2023.01.017. eCollection 2023 Apr.
The purpose of this study is to investigate if a biomechanical difference exists in the prerepair and postrepair states of the posterior inferior glenohumeral ligament (PIGHL) following anterior Bankart repair with respect to capsular tension, labral height, and capsular shift.
In this study, 12 cadaveric shoulders were dissected to the glenohumeral capsule and disarticulated. The specimens were loaded to 5-mm displacement using a custom shoulder simulator, and measurements were taken for posterior capsular tension, labral height, and capsular shift. We measured the capsular tension, labral height, and capsular shift of the PIGHL in its native state and following repair of a simulated anterior Bankart lesion.
We found that there was a significant increase in the mean capsular tension of the posterior inferior glenohumeral ligament (Δ = 2.12 ± 2.10 N; = .005), as well as posterior capsular shift (Δ = .362 ± 0.365 mm; = .018). There was no significant change in posterior labral height (Δ = 0.297 ± 0.667 mm; = .193). These results demonstrate the sling effect of the inferior glenohumeral ligament.
Although the posterior inferior glenohumeral ligament is not directly manipulated during an anterior Bankart repair, when the anterior inferior glenohumeral ligament is plicated superiorly, some of the tension is transmitted to the posterior glenohumeral ligament as a result of the sling effect.
Anterior Bankart repair with superior capsular plication results in an increased mean tension of the PIGHL. Clinically, this may contribute to shoulder stability.
本研究旨在探讨在进行前侧Bankart修复术后，肩肱下后韧带（PIGHL）修复前和修复后在关节囊张力、盂唇高度和关节囊移位方面是否存在生物力学差异。
在本研究中，对12具尸体肩部进行解剖，直至肩肱关节囊并使其脱臼。使用定制的肩部模拟器将标本加载至5毫米位移，并测量后侧关节囊张力、盂唇高度和关节囊移位。我们测量了PIGHL在其自然状态下以及模拟前侧Bankart损伤修复后的关节囊张力、盂唇高度和关节囊移位。
我们发现，肩肱下后韧带的平均关节囊张力显著增加（Δ = 2.12 ± 2.10 N；P = .005），后侧关节囊移位也显著增加（Δ = .362 ± 0.365 mm；P = .018）。后侧盂唇高度无显著变化（Δ = 0.297 ± 0.667 mm；P = .193）。这些结果证明了肩肱下韧带的吊带效应。
虽然在前侧Bankart修复过程中未直接处理肩肱下后韧带，但当前侧肩肱下韧带向上折叠时，由于吊带效应，一些张力会传递至后侧肩肱韧带。
采用上关节囊折叠术进行前侧Bankart修复会导致PIGHL的平均张力增加。临床上，这可能有助于提高肩部稳定性。
