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TECHNICAL PAPERS

Stability of Reconstructed Paralyzed Shoulders Using a Reflected Long Head Biceps Technique

[+] Author and Article Information
C. Y. Tang, A. F. T. Mak

Jockey Club Rehabilitation Engineering Center, The Hong Kong Polytechnic University, Kowloon, Hong Kong

L. K. Hung, H. S. Wong, T. Pacaldo

Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong

J Biomech Eng 123(3), 227-233 (Aug 31, 1999) (7 pages) doi:10.1115/1.1372700 History: Received August 31, 1999; Received January 11, 2001
Copyright © 2001 by ASME
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References

Kumar,  V. P., Satku,  K., and Balasubramaniam,  P., 1989, “The Role of the Long Head of Biceps Brachii in the Stabilization of the Head of the Humerus,'The Role of the Long Head of Biceps Brachii in the Stabilization of the Head of the Humerus,'’ Clin. Orthop., 244, pp. 172–175.
Lucas,  D. B., 1973, “Biomechanics of the Shoulder Joint,” Arch. Surg., 107, pp. 425–432.
Itoi,  E., Newman,  S. R., Kuechle,  D. K., Morrey,  B. F., and An,  K. N., 1994, “Dynamic Anterior Stabilisers of the Shoulder With the Arm in Abduction,” J. Bone Joint Surg., 76-B, pp. 834–863.
Itoi,  E., Kuechle,  D. K., Newman,  S. R., Morrey,  B. F., and An,  K. N., 1993, “Stabilising Function of the Biceps in Stable and Unstable Shoulders,” J. Bone Joint Surg., 75-B, pp. 546–550.
Glousman,  R., Jobe,  F., Tibone,  J., Moynes,  D., Antonelli,  D., and Perry,  J., 1988, “Dynamic Electromyographic Analysis of the Throwing Shoulder With Glenohumeral Instability,” J. Bone Joint Surg., 70A, pp. 20–26.
Grammont, P. M., Mayer, R. P., and Lohr, J. R., 1984 , “The Role of the Tendon of the Long Head of Biceps Brachii in Anterior Subluxation of the Shoulder,” Surgery of the Shoulder, Bateman, J. E., and Welsh, R. P., eds., C. V. Mosby, Philadelphia, pp. 104–105.
Itoi,  E., Motzkin,  N. E., Morrey,  B. F., and An,  K. N., 1994, “Stabilizing Function of the Long Head of Biceps in the Hanging Arm Position,” J. Shoulder Elbow Surg., 3, pp. 135–142.
Pagnani,  M. J., Deng,  X. H., Warren,  R. F., Torzilli,  P. A., and O'Brien,  S. J., 1996, “Role of the Long Head of the Biceps Brachii in Glenohumeral Stability: A Biomechanical Study in Cadavera,” J. Shoulder Elbow Surg., 5, pp. 255–262.
Rodosky,  M. W., Harner,  C. D., and Fu,  F. H., 1994, “The Role of the Long Head of the Biceps Muscle and Superior Glenoid Labrum in Anterior Stability of the Shoulder,” Am. J. Sports Med., 22, pp. 121–130.
Kuechle, D., 1994, “Shoulder Muscle Moment Arm During Horizontal Flexion, Rotation, and Elevation,” Master’s Thesis, The Mayo Graduate School, Rochester, MN.
Poppen,  N. K., and Walker,  P. S., 1976, “Normal and Abnormal Motion of the Shoulder,” J. Bone Joint Surg., 58A, pp. 195–201.
Ikai,  M., and Fukunaga,  T., 1968, “Calculation of Muscle Strength per Unit Cross-Sectional Area of Human Muscle by Means of Ultrasonic Measurement,” Int. Z. Angew. Physiol. Einschl. Arbeits Physiol., 26, pp. 26–32.
Veegar,  H. E. J., Van Der Helm,  F. C. T., Van Der Woude,  L. H. V., Pronk,  G. M., and Rozendal,  R. H., 1991, “Inertia and Muscle Contraction Parameters for Musculoskeletal Modelling of the Shoulder Mechanism,” J. Biomech., 24, pp. 615–629.
Milne,  A. D., Chess,  D. G., Johnson,  J. A., and King,  G. J. W., 1996, “Accuracy of an Electromagnetic Tracking Device: A Study of the Optimal Operating Range and Metal Interference,” J. Biomech., 29, pp. 791–793.
Bull,  A. M. J., and Amis,  A. A., 1997, “Accuracy of an Electromagnetic Tracking Device,” J. Biomech., 30, pp. 857–858.
Harryman,  D. T., Sidles,  J. A., Clark,  J. M., McQuade,  K. J., Gibb,  T. D., and Matsen,  F. A., 1990, “Translation of the Humeral Head on the Glenoid With Passive Glenohumeral Motion,” J. Bone Joint Surg., 72A, pp. 1334–1343.
Blasier,  R. B., Guldberg,  R. E., and Rothman,  E. D., 1992, “Anterior Shoulder Stability: Contributions of Rotator Cuff Forces and the Capsular Ligaments in a Cadaver Model,” J. Shoulder Elbow Surg., 1, pp. 140–150.
Cain,  P. R., Mutschler,  T. A., Fu,  F. H., and Lee  S. K., 1987, “Anterior Stability of the Glenohumeral Joint: a Dynamic Study,” Am. J. Sports Med., 15, pp. 144–148.
Harryman,  D. T., Sidles,  J. A., Harris,  S. L., and Matsen,  F. A., 1992, “The Role of the Rotator Interval Capsule in Passive Motion and Stability of the Shoulder,” J. Bone Joint Surg., 74A, pp. 53–65.
Inman,  V. T., deC. Saunder,  J. B., and Abbott,  L. C., 1944, “Observations on the Function of the Shoulder Joint,” J. Bone Joint Surg., 26A, pp. 1–30.
Itoi,  E., and Tabata,  S., 1992, “Rotator Cuff Tears in Anterior Dislocation of the Shoulder,” Int. Orthop., 16, pp. 240–244.
Itoi,  E., Motzkin,  N. E., Morrey,  B. F., and An,  K. N., 1993, “Bulk Effect of Rotator Cuff on Inferior Glenohumeral Stability as Function of Scapular Inclination Angle: a Cadaver Study,” Tohoku J. Exp. Med., 171, pp. 267–276.
Ovesen,  J., and Nielsen,  S., 1986, “Posterior Instability of the Shoulder. A Cadaver Study,” Acta Orthop. Scand., 57, pp. 436–439.
Saha,  A. K., 1971, “Dynamic Stability of the Glenohumeral Joint,” Acta Orthop. Scand., 42, pp. 491–505.
Sharkey,  N. A., and Marder,  R. A., 1995, “The Rotator Cuff Opposes Superior Translation of the Humeral Head,” Am. J. Sports Med., 23, pp. 270–275.
Soslowsky,  L. J., Carpenter,  J. E., Bucchieri,  J. S., and Flatow,  E. L., 1997, “Biomechanics of the Rotator Cuff,” Orthop. Clin. North Am., 28, pp. 17–30.
Neer, C. S., II, 1990, Shoulder Reconstruction, W. B. Saunders Company, Philadelphia.
Warner,  J. J., and McMahon,  P. J., 1995, “The Role of the Long Head of the Biceps Brachii in Superior Stability of the Glenohumeral Joint,” J. Bone Joint Surg., 77A, pp. 366–372.
Lippitt,  S. B., Vanderhooft,  J. E., Harris,  S. L., Sidles,  J. A., Harryman,  D. T., and Matsen,  F. A., 1993, “Glenohumeral Stability From Concavity–Compression: A Quantitative Analysis,” J. Shoulder Elbow Surg., 2, pp. 27–35.
Itoi,  E., Motzkin,  N. E., Morrey,  B. F., and An,  K. N., 1992, “Scapular Inclination and Inferior Stability of the Shoulder,” J. Shoulder Elbow Surg., 1, pp. 131–139.

Figures

Grahic Jump Location
Experimental settings of the stability study (anterior view of specimen in 90 deg humeral elevation)
Grahic Jump Location
(a) Anterior view of shoulder, with deltoid muscle retracted; the LHB was detached from the biceps muscle and reflected proximally at the transverse ligament; (b) and (c) anterior view through deltoid approach: (b) showing exit of the RLHB tendon, anterior to clavicle through fibers of deltoid muscle (c) view without deltoid muscle
Grahic Jump Location
Through-deltoid tendon transfer using the RLHB tendon (posterior view of reconstructed shoulder in 90 deg humeral elevation)
Grahic Jump Location
Subdeltoid approach, superioposterior view: (a) showing exit of RLHB tendon at posterior part of deltoid; (b) view without deltoid muscle
Grahic Jump Location
Subdeltoid tendon transfer using RLHB tendon (posterior view of reconstructed shoulder in 90 deg humeral elevation)
Grahic Jump Location
Displacement of center of humeral head (pre-operation) in response to 1.5 kg anterior load with intact joint (mean ± SEM). Effect of humeral rotation on displacement was not statistically significant. (Baseline=no load applied to muscles.) For post-operation condition, RLHB was directed to upper part of trapezius.
Grahic Jump Location
Displacement of center of humeral head (post-operation) in response to 1.5 kg anterior load with intact joint (mean ± SEM). Humerus was rotated from 0 to 45 deg externally. For post-operation condition, RLHB was directed to upper part of trapezius.
Grahic Jump Location
Displacement of center of humeral head (pre- and post-operation) in response to 1.5 kg anterior load of intact joint and after tendon transfer with no external rotation (mean ± SEM). For post-operation condition, RLHB was directed to upper part of trapezius.
Grahic Jump Location
Displacement of center of humeral head in response to 1.5 kg anterior load after tendon transfer (mean ± SEM). Reflected long head biceps was directed to upper, middle, and lower parts of trapezius.
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loadings (through-deltoid technique, 0 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (subdeltoid technique, 0 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (through-deltoid technique, 45 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (subdeltoid technique, 45 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (through-deltoid technique, 90 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (through-deltoid technique, 90 deg elevation with 45 deg ER, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (subdeltoid technique, 90 deg elevation, measurements in mm, mean ± SEM)
Grahic Jump Location
Total displacement of center of humeral head under inferior or posterior loading (subdeltoid technique, 90 deg elevation with 45 deg ER, measurements in mm, mean ± SEM)

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