Glenohumeral stability from concavity-compression: A quantitative analysis

Abstract

The purpose of this research was to determine the degree to which compression of the humeral head into the glenoid concavity stabilizes it against translating forces. Ten normal fresh-frozen cadaver glenohumeral joints in which the labrum was preserved were used. A compressive load of 50 N was applied to the humeral head in a direction perpendicular to the glenoid surface. Increasing tangential forces were then applied until the head dislocated over the glenoid lip. The tangential force at dislocation was examined for eight different directions, 45° apart around the glenoid. Concavity-compression stability was then examined for an increased compressive load of 100 N. Finally, the protocol with 50 and 100 N of compressive load was repeated after the glenoid labrum was excised. Concavity-compression of the humeral head into the glenoid is a most efficient stabilizing mechanism. With the labrum intact the humeral head resisted tangential forces of up to 60% of the compressive load. The degree of compression stabilization varied around the circumference of the glenoid with the greatest magnitude superiorly and inferiorly. This may be attributed to the greater glenoid depth in these directions. Resection of the glenoid labrum reduced the effectiveness of compression stabilization by approximately 20%. These results indicate that concavity-compression may be an important mechanism for providing stability in the mid-range of glenohumeral motion where the capsule and ligaments are lax. The effectiveness is enhanced by the presence of an intact glenoid labrum.