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. 2023 May 22;13(10):1819.
doi: 10.3390/diagnostics13101819.

Image-Based Numerical Analysis for Isolated Type II SLAP Lesions in Shoulder Abduction and External Rotation

Javier A Maldonado  1 , Duvert A Puentes  2 , Ivan D Quintero  3 , Octavio A González-Estrada  2 , Diego F Villegas  2
Affiliations

Image-Based Numerical Analysis for Isolated Type II SLAP Lesions in Shoulder Abduction and External Rotation

Javier A Maldonado et al. Diagnostics (Basel). .

Abstract

The glenohumeral joint (GHJ) is one of the most critical structures in the shoulder complex. Lesions of the superior labral anterior to posterior (SLAP) cause instability at the joint. Isolated Type II of this lesion is the most common, and its treatment is still under debate. Therefore, this study aimed to determine the biomechanical behavior of soft tissues on the anterior bands of the glenohumeral joint with an Isolated Type II SLAP lesion. Segmentation tools were used to build a 3D model of the shoulder joint from CT-scan and MRI images. The healthy model was studied using finite element analysis. Validation was conducted with a numerical model using ANOVA, and no significant differences were shown (p = 0.47). Then, an Isolated Type II SLAP lesion was produced in the model, and the joint was subjected to 30 degrees of external rotation. A comparison was made for maximum principal strains in the healthy and the injured models. Results revealed that the strain distribution of the anterior bands of the synovial capsule is similar between a healthy and an injured shoulder (p = 0.17). These results demonstrated that GHJ does not significantly deform for an Isolated Type II SLAP lesion subjected to 30-degree external rotation in abduction.

Keywords: biomechanics; computational biomechanics; glenohumeral joint; isolated type II SLAP; nonsurgical treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Humerus presenting the epiphyseal sphere insertion and the metaphyseal cylinder front view, (B) model top view.
Figure 2
Figure 2
(A) Shoulder in the neutral position on the top view, (B) shoulder in the neutral position on the front view, (C) shoulder bones in the initial position on the front view.
Figure 3
Figure 3
Shoulder with the capsule divided into five sections according to their material.
Figure 4
Figure 4
(A) Glenohumeral capsule posterior view, (B) glenohumeral capsule anterior view.
Figure 5
Figure 5
(a) Front view, and (b) isometric view for the boundary conditions applied to the 3D model: uniformly distributed pressure caused by the synovial capsule (A), external rotation applied on the humerus in the axial direction (B), and labrum fixed boundary (C).
Figure 6
Figure 6
The glenoid labral division in time zones used to define subtypes of SLAP lesions. From 12 to 1: anterior SLAP, from 11 to 12: posterior SLAP, and from 11 to 1: anterior to posterior SLAP.
Figure 7
Figure 7
Maximum principal strain for the healthy glenohumeral joint and an injured joint (Isolated Type II SLAP lesion) at 30° with an anterior Isolated Type II SLAP.
Figure 8
Figure 8
Maximum principal strain distribution for the healthy glenohumeral joint and injured joint (Isolated Type II SLAP lesion) at 30° with an anterior Isolated Type II SLAP. The other three lesion cases have the same performance.
See this image and copyright information in PMC

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