The Journal of Bone and Joint Surgery 78:94-102 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.
Effect of a Chondral-Labral Defect on Glenoid Concavity and Glenohumeral Stability. A Cadaveric Model*
MARK D. LAZARUS, M.D. ,
JOHN A. SIDLES, PH.D. ,
DOUGLAS T. HARRYMAN II, M.D. and
FREDERICK A. MATSEN III, M.D., SEATTLE, WASHINGTON
Investigation performed at the Department of Orthopaedic Surgery, University of Washington Medical Center, Seattle
One of the primary stabilizing mechanisms of the glenohumeral joint is concavity-compression, the maintenance of the humeral head in the concave glenoid fossa by the compressive force generated by the surrounding muscles. This mechanism is active in all glenohumeral positions but it is particularly important in the functional mid-range, in which the capsule and ligaments are slack. The effectiveness of concavity-compression in the stabilization of a joint can be characterized in terms of the ratio between the maximum dislocating force that can be stabilized in a given direction and the load compressing the head into the glenoid (the stability ratio). Glenoid concavity can be described by the lateral humeral displacement during translation across the glenoid. The purpose of the present investigation was to characterize the concavity and stability ratios of normal cadaveric glenoids, to measure the effect of an anteroinferior chondral-labral defect on these parameters, and to measure the effectiveness of a simulated operative reconstruction on the restoration of glenoid concavity and the stability ratio.
The chondral-labral defect created in this study reduced the height of the glenoid by approximately 80 per cent and the stability ratio by approximately 65 per cent for translation in the direction of the defect. Reconstruction of the anteroinferior aspect of the glenoid concavity with use of an autogenous biceps-tendon graft restored normal values for these variables.
CLINICAL RELEVANCE: Loss of glenoid concavity may be an important factor in glenohumeral instability, and reconstruction of this concavity may effectively restore stability.
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