The role of negative intraarticular pressure and the long head of biceps tendon on passive stability of the glenohumeral joint

Background The purpose of this study was to determine the effect of intraarticular pressure and the long head of biceps (LHB) tendon on passive translations of the glenohumeral (GH) joint. Tenotomy or tenodesis of the LHB are common procedures but the consequences on shoulder stability are unclear....

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2013, Vol.22 (1), p.94-101
Main Authors: Alexander, Susan, PhD, FRCS, Southgate, Dominic F.L., PhD, Bull, Anthony M.J., PhD, Wallace, Andrew L., PhD, FRACS
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biceps
biomechanics
Cadaver
Female
glenohumeral joint
Humans
kinematics
Male
Middle Aged
Orthopedics
Pressure
Shoulder Joint - physiology
stability
Tendons - physiology
tenotomy
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Summary:Background The purpose of this study was to determine the effect of intraarticular pressure and the long head of biceps (LHB) tendon on passive translations of the glenohumeral (GH) joint. Tenotomy or tenodesis of the LHB are common procedures but the consequences on shoulder stability are unclear. Methods A novel shoulder laxity testing rig permitting six degrees of freedom of motion was used to test passive translations in anterior, posterior, superior, and inferior directions in 10 cadaveric shoulders. Specimens were tested in neutral rotation with 0°, 30°, 60°, or 90° of GH abduction in the scapular plane. Translation loads up to 30N were applied, and displacements measured in an intact joint, vented joint and with the biceps tendon loaded (20N). Results The GH joint was most lax at 30° GH abduction. Venting of the joint increased translations in all positions and directions (mean ± standard error of the mean), the greatest difference was 12.5 (3.9) mm in the anterior–posterior direction and 7.5 (3.9) mm in the SI direction. Loading the LHB tendon with 20N decreased translations in all directions. The largest difference was observed in the anterior direction, 13.9 (2.8) mm ( P < .0005) and inferior direction, 12.0 (2.8) mm ( P < .0005). Conclusion Negative intraarticular pressure and the LHB contribute significantly to overall passive stability of the GH joint. Surgical division or transfer of the LHB tendon may impact on joint stability and function.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2012.01.007