Abstract
BackgroundAlthough conventional Bankart repair has been the accepted procedure for traumatic anterior glenohumeral instability, the humeral avulsion of the glenohumeral ligament or an elongation of the capsule remains challenging to decide the appropriate treatment. The anatomical knowledge regarding the whole capsule of glenohumeral joint is necessary to accurately treat for the capsular disorders. The aims of the current study were to investigate the anatomical features of capsular attachment and thickness in a whole capsule of glenohumeral joint.MethodsWe used 13 shoulders in the current study. In 9 shoulders, we macroscopically measured the attachment widths of the capsulolabrum complex on the scapular glenoid, and the attachment widths of the capsule on the humerus in reference to the scapular origin of the long head of triceps brachii, and the humeral insertion of the rotator cuff tendons. We additionally used 4 cadaveric shoulders, which were embalmed using Thiel’s method, for the analysis of the thickness in a whole capsule by using micro-CT.ResultsThe glenoidal attachment of the articular capsule appeared to have a consistent width except for the superior part of the origin of the long head of triceps brachii. On the humerus, the articular capsule was widely attached to areas without overlying rotator cuffs, with the widest width (17.3 ± 0.9 mm) attached to the axillary pouch. The inferior part of the capsule, which was consistently thicker than the superior part, continued to the superior part along the glenoid and humeral side edge.ConclusionsThe current study showed that the inferior part of the glenohumeral capsule had a wide humeral attachment from the inferior edge of the subscapularis insertion to the inferior edge of the teres minor insertion via the anatomical neck of the humerus, and the thickness of it was thicker than the superior part of the capsule.
Highlights
Conventional Bankart repair has been the accepted procedure for traumatic anterior glenohumeral instability, the humeral avulsion of the glenohumeral ligament or an elongation of the capsule remains challenging to decide the appropriate treatment
Momma et al Journal of Experimental Orthopaedics (2018) 5:16 glenohumeral joint.(Nimura and Akita 2013) Recently, it has been though that anatomical knowledge regarding the relatively wide attachment of the joint capsule could be helpful for the understanding the joint stabilizing in other joints.(Nasu et al 2017; Nimura et al 2014; Sato et al 2018; Shimura et al 2016) the anterior and inferior attachments of the articular capsule, which is generally referred as the inferior glenohumeral ligament, on the humerus has been remained controversial
Measurements for widths of the area of capsular attachments Regarding the glenoidal attachment of the articular capsule, we could not separate the capsule from the labrum
Summary
Conventional Bankart repair has been the accepted procedure for traumatic anterior glenohumeral instability, the humeral avulsion of the glenohumeral ligament or an elongation of the capsule remains challenging to decide the appropriate treatment. Momma et al Journal of Experimental Orthopaedics (2018) 5:16 glenohumeral joint.(Nimura and Akita 2013) Recently, it has been though that anatomical knowledge regarding the relatively wide attachment of the joint capsule could be helpful for the understanding the joint stabilizing in other joints.(Nasu et al 2017; Nimura et al 2014; Sato et al 2018; Shimura et al 2016) the anterior and inferior attachments of the articular capsule, which is generally referred as the inferior glenohumeral ligament, on the humerus has been remained controversial. Our objectives were as follows: 1) to measure the width of the capsular attachments on both the humerus and glenoid edge of the scapula, and 2) to comprehensively analyze the thickness measurements of the whole capsule in association with the corresponding attachments on bones. We hypothesize that the attachment widths of the shoulder joint capsule vary in association with the bony location, and correlate with the local thickness of the whole capsule
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