Effect of perfect anatomic repair, imperfect anatomic repair, and no repair of a 25% Hill-Sachs lesion on bony contact and capsular forces at the glenohumeral joint.pdfVIP

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Effect of perfect anatomic repair, imperfect anatomic repair, and no repair of a 25% Hill-Sachs lesion on bony contact and capsular forces at the glenohumeral joint.pdf

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Effect of perfect anatomic repair, imperfect anatomic repair, and no repair of a 25% Hill-Sachs lesion on bony contact and capsular forces at the glenohumeral joint.pdf

ORTHTR 10906 No. of Pages 8 Orthopaedics Traanud matology ORIGINAL PAPER Sports Orthop. Traumatol. xx, xx–xx (2016) C Elsevier GmbH www.SOT /10.1016/j.orthtr.2016.12.002 Summary Background: To compare the impact of a 25% Hill-Sachs lesion (defect condition, D) and perfect and imperfect anatomic repairs (PAR and IAR) of such lesions on glenohumeral bony contact and capsular forces in response to compressive and anterior loads. Material and methods: A robotic/universal force-moment sensor testing system applied joint compression (22 N) and an anterior load (44 N) to cadaveric shoulders (n = 9) at three glenohumeral joint positions (abduction/external rotation): 08/08, 308/308, and 608/608. The 25% bony defect state, PAR state, and IAR state were created and the loading protocol was performed. Bony contact/capsular forces were measured in each position for each shoulder state. Results: PAR had the least biomechanical impact on the bony surfaces and capsule of the glenohumeral joint. D had less impact on the bones and capsule compared to the IAR. The bony surfaces and capsule of the glenohumeral joint sustained the greatest forces in the IAR condition. Conclusions: The PAR state had the least force applied to the bony surfaces and capsule of the glenohumeral joint. The defect shoulder had signi?cantly less force applied to the bones and capsule of the glenohumeral joint compared to the IAR (greatest force applied). Performing an osteoallograft repair that does not fully restore normal anatomy may result in abnormal bony contact/capsular forces, resulting in joint wear, arthritis, and injury to the surrounding capsule. Clinical relevance: The importance of performing an osteoallograft repair of a Hill-Sachs defect that closely matches the pre-injury state and restores normal humeral head anatomy. Keywords Shoulder – Hill-Sachs lesion – Glenohumeral joint – Bony contact – Capsular force N.K. Bakshi et al. Ein?uss einer perfekten anatomischen Rekonstruktion, mangelhaften