Biomedical subjects

L J Soslowsky

Publications and source records attributed to L J Soslowsky.

34 records · Page 2Linked to original sources

PubMed1994

Computer simulation of glenohumeral and patellofemoral subluxation. Estimating pathological articular contact.

Analytic stereophotogrammetry and an interactive computer graphics program were used to obtain first order assessments of joint contact patterns in patellofemoral and glenohumeral joints, simulating normal and abnormal articulations. Precise (90 microns accuracy) computer graphic representations of the humeral head, glenoid, patella, and femoral articular surfaces were obtained from cadaver knees and shoulders. These surface representations were then manipulated into an articulated position, and joint contact areas computed by a proximity criterion. Pathologic states were then simulated, and contact recomputed. Simulated glenohumeral subluxations dramatically reduced contact area, and focused it eccentrically on the glenoid rim. Simulated size mismatch of humeral heads to glenoids reduced contact area, producing a pattern of peripheral contact on the glenoid if the humeral head had a larger radius of curvature, and central contact on the glenoid if the humeral head had a smaller radius of curvature. At 30 degrees knee flexion, the patellofemoral joint demonstrated a broad distribution of contact along the distal aspect of the patella and proximal aspect of the trochlea. Simulated lateral tilt (5 degrees) and translation (5 mm) of the patella resulted in shift of the predominant contact area laterally, along with a drastic decrease in the contact area. These results have implications for prosthetic sizing and biomechanical modeling of the glenohumeral and patellofemoral joints, and in selecting models for more rigorous empiric studies of joint contact. Furthermore, this technique allows a first order assessment of the effects of specific surgical reconstructions on articular mechanics.

Computer Graphics↗

PubMed1992

Tensile properties of the inferior glenohumeral ligament.

The tensile properties of the inferior glenohumeral ligament have been determined in 16 freshly frozen cadaver shoulders. The inferior glenohumeral ligament was divided into three anatomical regions: a superior band, an anterior axillary pouch, and a posterior axillary pouch. This yielded 48 bone-ligament-bone specimens, which were tested to failure in uniaxial tension. The superior band was consistently the thickest region, averaging 2.79 mm. The thickness of the inferior glenohumeral ligament decreased from antero-superiorly to postero-inferiorly. The resting length of all three anatomical regions was not statistically different. Total specimen strain to failure for all bone-ligament-bone specimens averaged 27%. Variations occurred between the three regions, with the anterior pouch specimens failing at a higher strain (34%) than those from the superior band (24%) or the posterior pouch (23%). Strain to failure for the ligament midsubstance (11%) was found to be significantly less than that for the entire specimen (27%). Thus, larger strain must occur near the insertion sites of the inferior glenohumeral ligament. Stress at failure was found to be nearly identical for the three regions of the ligament, averaging 5.5 MPa. These values are lower than those reported for other soft tissues, such as the anterior cruciate ligament and patellar tendon. The anterior pouch was found to be less stiff than the other two regions, perhaps suggesting that it is composed of more highly crimped collagen fibers. Three failure sites were seen for the inferior glenohumeral ligament: the glenoid insertion (40%), the ligament substance (35%), and the humeral insertion (25%). In addition, significant capsular stretching occurred before failure, regardless of the failure mode.

Aged↗

PubMed1992

Quantitation of in situ contact areas at the glenohumeral joint: a biomechanical study.

Glenohumeral arthritis may result from abnormal articular mechanics, and shoulder reconstructive procedures often rely implicitly on the belief that the restoration of normal articular mechanics is required to obtain satisfactory clinical results. Despite this, limited knowledge of normal or pathologic glenohumeral joint articular mechanics and contact is available. This study uses a stereophotogrammetry technique to determine contact areas in normal cadaver glenohumeral joints with intact ligaments and capsule through a large range of motion using simulated forces of the four rotator cuff muscles and three deltoid heads. All shoulders were first elevated to their maximum elevation in the scapular plane at an external rotation (starting rotation = 40 +/- 8 degrees), which allowed each shoulder to attain its maximal elevation in the scapular plane, and then repeated at 20 degrees internal to this rotation. Contact areas consistently increased with increasing elevation until 120 degrees to an average of 5.07 cm2 before decreasing with further increased elevation to an average of 2.59 cm2 at 180 degrees of total arm elevation. At 20 degrees internal to the starting rotation, contact areas reached high values 60 degrees earlier (averaged 4.56 cm2 at 60 degrees of total arm elevation) and then remained fairly constant through 120 degrees before decreasing with further increased elevation to 2.51 cm2 at 180 degrees total arm elevation. With increasing elevation in the external starting rotation, humeral head contact dramatically migrates from an inferior region to a superocentral-posterior region while glenoid contact shifts posteriorly. When the humeral shaft is positioned 20 degrees internal to the starting rotation, humeral head contact shifts from inferocentral-anterior to superocentral-posterior regions. Simultaneously, a similar posterior shift in glenoid contact is observed. Furthermore, whereas only a small portion of the humeral head surface area is in contact in any given position, contact on the glenoid surface is much more uniformly distributed over its entire articulating surface.

Aged↗

PubMed1992

Articular geometry of the glenohumeral joint.

Little quantitative data exists defining the true shape of the humeral head and glenoid articular surfaces. This study uses a precise stereophotogrammetry (SPG) technique and provides highly accurate quantitative results for determining the three-dimensional geometry of glenohumeral joint articular surfaces, including their "sphericity", surface areas, cartilage thickness, and the difference in these quantities between the genders. Results indicate that glenohumeral joint surfaces may be approximated by a section of a sphere with small deviations from sphericity of less than 1% of the radius. Furthermore, results indicate that mating humeral head and glenoid articular surfaces are quite congruent and have radii within 2 mm in 88% of cases, and within 3 mm in all cases measured. The lack of anatomic stability of this joint is therefore not attributable to the relative shallowness or lack of congruence of the joint but rather to the small surface area of the glenoid which does not enclose the humeral head. Cartilage thickness results may partially explain perceptions of glenohumeral incongruity obtained from roentgenographic measurements where the glenoid appears flatter than the corresponding humeral head. Only when the actual articular cartilage surfaces are analyzed is it determined that the actual articulating surfaces do conform.

Aged↗

PubMed1991

Quantitation of articular surface topography and cartilage thickness in knee joints using stereophotogrammetry.

An analytical stereophotogrammetry (SPG) technique has been developed based upon some of the pioneering work of Selvik [Ph.D. thesis, University of Lund, Sweden (1974)] and Huiskes and coworkers [J. Biomechanics 18, 559-570 (1985)], and represents a fundamental step in the construction of biomechanical models of diarthrodial joints. Using this technique, the precise three-dimensional topography of the cartilage surfaces of various diarthrodial joints has been obtained. The system presented in this paper delivers an accuracy of 90 microns in the least favorable conditions with 95% coverage using the same calibration method as Huiskes et al. (1985). In addition, a method has been developed, using SPG, to quantitatively map the cartilage thickness over the entire articular surface of a joint with a precision of 134 microns (95% coverage). In the present study, our SPG system has been used to quantify the topography, including surface area, of the articular surfaces of the patella, distal femur, tibial plateau, and menisci of the human knee. Furthermore, examples of cartilage thickness maps and corresponding thickness data including coefficient of variation, minimum, maximum, and mean cartilage thickness are also provided for the cartilage surfaces of the knee. These maps illustrate significant variations over the joint surfaces which are important in the determination of the stresses and strains within the cartilage during diarthrodial joint function. In addition, these cartilage surface topographies and thickness data are essential for the development of anatomically accurate finite element models of diarthrodial joints.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[Relationship of acromial architecture and diseases of the rotator cuff].

Variations in the architecture of the coraco-acromial arch can lead to a clinically symptomatic rotator cuff lesion. Differences in the shape and slope of the acromion, anterior acromial spurs and inferior protruding acromio-clavicular osteophytes decrease the volume of the subacromial space, leading to impingement. Recent anatomic, radiographic, biomechanic and stereophotogrammetric studies have confirmed these architectural variations and their effect on the contents of the subacromial space. Abnormal contact between the acromion and these soft tissues can result in pathological lesions. Surgical procedures should be aimed at increasing the space beneath the coraco-acromial arch to reduce wear on the rotator cuff.

Acromioclavicular Joint↗

PubMed1991

The relationship of acromial architecture to rotator cuff disease.

Variations in the architecture of the coracoacromial arch can lead to a clinically symptomatic rotator cuff lesion. Differences in the development and morphology of the acromion, and the presence of anterior acromial spurs and inferior acromioclavicular osteophytes decrease the volume of the subacromial space, leading to impingement. Recent anatomic, radiographic, biomechanical, and SPG studies have confirmed these architectural variations and their effects on the contents of the subacromial space. Abnormal contact between the acromion and these soft tissues can lead to pathologic lesions. Surgical procedures should be directed at increasing the space beneath the coracoacromial arch to reduce wear on the rotator cuff.

Acromioclavicular Joint↗

PubMedDate not supplied

Inferior glenohumeral ligament: geometric and strain-rate dependent properties.

The inferior glenohumeral ligament (IGHL) is an important structure for maintaining shoulder stability. This study was aimed at determining the geometric and anatomic characteristics of the IGHL and its tensile properties at a higher strain rate than previously tested. Eight fresh-frozen human cadaver shoulders (average age 69 years, age range 62 to 73 years) from four female and four male cadavers were used to harvest bone-ligament-bone specimens from the three regions of the IGHL (superior band, anterior axillary pouch, and posterior axillary pouch). Uniaxial tensile tests were performed at the moderately high strain rate of approximately 10% per second with a servo-hydraulic testing machine. This represented a strain rate that was approximately 100 to 1000 times faster than that previously reported. During tensile testing, bone-ligament-bone strains were calculated from grip-to-grip motion on the testing machine, and mid-substance strains were determined by a video dimensional analyzer. Although all regions of the IGHL had similar lengths (averaging 43.4 mm), their thickness varied by region and by proximal-to-distal location. The superior band was the thickest (2.23 +/- 0.38 mm) of the three regions. Of the remaining two regions the anterior axillary pouch (1.94 +/- 0.38 mm) was thicker than the posterior axillary pouch (1.59 +/- 0.64 mm). By proximal-to-distal location the IGHL was thicker for all three regions near the glenoid (2.30 +/- 0.57 mm) than near the humerus (1.61 +/- 0.52 mm). The superior band had a greater stiffness (62.63 +/- 9.78 MPa) than either the anterior axillary pouch (47.75 +/- 17.89 MPa) or the posterior axillary pouch (39.97 +/- 13.29 MPa). Tensile stress at failure was greater in the superior band (8.4 +/- 2.2 MPa) and the anterior axillary pouch (7.8 +/- 3.1 MPa) than the posterior axillary pouch (5.9 +/- 1.7 MPa). The anterior axillary pouch demonstrated greater bone-to-bone and mid-substance strains (30.4% +/- 4.3% and 10.8% +/- 2.4%, respectively) before failure than the other two regions (superior band: 20.8% +/- 3.8% and 9.1% +/- 2.8%, respectively; posterior axillary pouch: 25.2% +/- 5.8% and 7.8% +/- 2.6%, respectively). Bone-to-bone strain was always greater than mid-substance strain, indicating that when the IGHL is stretched, the tissue near the insertion sites will experience much greater strain than the tissue in the mid-substance. insertion failures were more likely at slower strain rates, and ligamentous failures were predominant at the fast strain rate. When compared with other tensile studies of the IGHL at slower strain rates (0.01% per second and 0.1% per second), the superior band and the anterior axillary pouch demonstrated the viscoelastic effects of increased stiffness and failure stress. This superior band and anterior axillary pouch pouch viscoelastic stiffening effect suggests that these two regions may function to restrain the humeral head from rapid abnormal anterior displacement in the clinically vulnerable position of abduction and external rotation.

Aged↗

PubMedDate not supplied

Development and use of an animal model for investigations on rotator cuff disease.

Although both intrinsic and extrinsic factors have been implicated in the cause of rotator cuff disease, previous studies have not been designed to test hypotheses of this disease, partly because of the lack of an appropriate animal model. Thirty-three animals were evaluated according to a 34 item checklist of criteria to determine their appropriateness as an animal model for investigations on the rotator cuff. Only the rat shoulder satisfactorily fulfilled all criteria, with a prominent supraspinatus tendon passing under an enclosed arch. Once the rat was identified, 36 rats were randomized to three experimental groups. One group (n = 12) was treated with an intratendinous injection of bacterial collagenase simulating an acute intrinsic injury, another group (n = 12) was treated with an acromial alteration to reduce the subacromial space simulating an external compression, and the third group (n = 12) was treated with a combination of both modifications. Significant increases in cellularity, number of fibroblasts, and collagen disorganization were seen in all experimental tendons compared with a contralateral control group. Semiquantitative grading of histologic sections revealed marked changes in all groups at 4 and 8 weeks. Injuries appeared to be healing at 12 weeks except in the combination group, which seemed to demonstrate persistent alterations. This study supports the rat as an appropriate model for investigating rotator cuff disease. In addition, this study demonstrates that both intrinsic and extrinsic alterations can induce changes in the supraspinatus tendon, which may have similarities to human tendon disease.

Animals↗

PubMedDate not supplied

Active and passive factors in inferior glenohumeral stabilization: a biomechanical model.

This study examines the stabilizing factors of the glenohumeral joint against inferior translation over a range of subluxations. Factors examined included the glenohumeral capsular ligaments, the coracohumeral ligament, the rotator cuff forces, and the long head of the biceps force. Simulated muscle forces were applied to eight shoulder specimens with the arm near 0 degrees abduction. Stability was defined as the force required to inferiorly sublux the joint to a specified translation from the centered position and was evaluated under varying configurations of capsule cuts, humeral rotation, and muscle loads. The supraspinatus and biceps muscle forces were found to be important active stabilizers. Thus, tension in the long head of the biceps did not tend to depress the humeral head. The inferior glenohumeral ligament was an important passive stabilizer in external rotation. Understanding the effects of these factors adds insight into the underlying biomechanics of clinical shoulder instability.

Biomechanical Phenomena↗

PubMedDate not supplied

Rotator cuff defect healing: a biomechanical and histologic analysis in an animal model.

Rotator cuff tears are one of the most common causes of pain and disability in the upper extremity. With the use of an animal model, we studied the healing response of a controlled defect in the normal supraspinatus tendon and in a tendon with a reduced intrinsic healing capacity. In 36 Sprague-Dawley rats, defects (2 mm x 2 mm) were created in the supraspinatus tendons bilaterally. To model a tendon with an intrinsically reduced capacity to heal, the tissue adjacent to the defect area in the left shoulder was treated with in situ freezing. The contralateral tendon was not frozen. After 3 (n = 12), 6 (n = 12), and 12 (n = 12) weeks, animals were killed and underwent histologic (n = 4 from each group) and biomechanical (n = 8 from each group) evaluation. An additional group of untreated animals served as a normal control group. On histologic evaluation 78% of tendons had persistent defects (defined as incomplete closure of the defect site). Over time, the tissue from both groups demonstrated an improved histologic grade but did not reach normal levels, even at 12 weeks. No histologic differences were found between defect healing in normal tendons and in those treated with in situ freezing. On biomechanical evaluation there were also no significant differences between treatment groups. Over time, an improvement occurred in tissue properties, indicating that some healing of the defects had occurred. However, these tissue properties remained an order of magnitude lower than those of normal control tendons. These findings indicate that there is an active but inadequate repair response to the defect in the rat supraspinatus tendon, which is not significantly worsened by in situ freezing of the tissue around the defect. This model has applications toward the study of techniques to improve or accelerate cuff defect healing.

Animals↗

PubMedDate not supplied

The mechanism of creation of superior labrum, anterior, and posterior lesions in a dynamic biomechanical model of the shoulder: the role of inferior subluxation.

Lesions of the superior glenoid labrum are a source of shoulder disease. However, the mechanisms of injury to this region are unknown, and controversy exists regarding the role of shoulder instability in creation of this lesion. With a cadaver model that simulates physiologic rotator cuff forces and produces traction on the biceps tendon, the creation of type II superior labrum, anterior, and posterior (SLAP) lesions and the role of glenohumeral subluxation were investigated: Left and right shoulders from each of 8 paired cadavers (age 62 +/- 7.2 years, 5 male and 3 female) were randomized to be tested in either a 20 mm inferiorly subluxed position or in a reduced position. The long head of the biceps tendon was held near the musculotendinous junction with a novel cryogenic clamp. Traction on the long head of the biceps tendon was applied at a fast rate of 12.7 cm/sec with a servohydraulic testing machine. A load cell was used to monitor the biceps tendon load. After testing to failure, the presence or absence of a type II SLAP lesion was determined by 2 experienced shoulder surgeons masked to the test group. The production of type II SLAP lesions differed significantly (P = .03) between reduced shoulders (2 SLAP lesions out of 8 tests) and the shoulders with inferior subluxation (7 SLAP lesions out of 8 tests). This experiment has shown that traction on the biceps tendon in this biomechanical model can reproducibly create type II SLAP lesions, and inferior subluxation facilitates the generation of such lesions.

Aged↗

PubMedDate not supplied

Ligamentous restraints to external rotation of the humerus in the late-cocking phase of throwing. A cadaveric biomechanical investigation.

The late-cocking phase of throwing is characterized by extreme external rotation of the abducted arm; repeated stress in this position is a potential source of glenohumeral joint laxity. To determine the ligamentous restraints for external rotation in this position, 20 cadaver shoulders (mean age, 65 +/- 16 years) were dissected, leaving the rotator cuff tendons, coracoacromial ligament, glenohumeral capsule and ligaments, and coracohumeral ligament intact. The combined superior and middle glenohumeral ligaments, anterior band of the inferior glenohumeral ligament, and the entire inferior glenohumeral ligament were marked with sutures during arthroscopy. Specimens were mounted in a testing apparatus to simulate the late-cocking position. Forces of 22 N were applied to each of the rotator cuff tendons. An external rotation torque (0.06 N x m/sec to a peak of 3.4 N x m) was applied to the humerus of each specimen with the capsule intact and again after a single randomly chosen ligament was cut (N = 5 in each group). Cutting the entire inferior glenohumeral ligament resulted in the greatest increase in external rotation (10.2 degrees +/- 4.9 degrees). This was not significantly different from sectioning the coracohumeral ligament (8.6 degrees +/- 7.3 degrees). The anterior band of the inferior glenohumeral ligament (2.7 degrees +/- 1.5 degrees) and the superior and middle glenohumeral ligaments (0.7 degrees +/- 0.3 degrees) were significantly less important in limiting external rotation.

Aged↗

PubMedDate not supplied

Excursion of the rotator cuff under the acromion. Patterns of subacromial contact.

Nine fresh-frozen, human cadaveric shoulders were elevated in the scapular plane in two different humeral rotations by applying forces along action lines of rotator cuff and deltoid muscles. Stereophotogrammetry determined possible regions of subacromial contact using a proximity criterion; radiographs measured acromiohumeral interval and position of greater tuberosity. Contact starts at the anterolateral edge of the acromion at 0 degrees of elevation; it shifts medially with arm elevation. On the humeral surface, contact shifts from proximal to distal on the supraspinatus tendon with arm elevation. When external rotation is decreased, distal and posterior shift in contact is noted. Acromial undersurface and rotator cuff tendons are in closest proximity between 60 degrees and 120 degrees of elevation; contact was consistently more pronounced for Type III acromions. Mean acromiohumeral interval was 11.1 mm at 0 degrees of elevation and decreased to 5.7 mm at 90 degrees, when greater tuberosity was closest to the acromion. Radiographs show bone-to-bone relationship; stereophotogrammetry assesses contact on soft tissues of the subacromial space. Contact centers on the supraspinatus insertion, suggesting altered excursion of the greater tuberosity may initially damage this rotator cuff region. Conditions limiting external rotation or elevation may also increase rotator cuff compression. Marked increase in contact with Type III acromions supports the role of anterior acromioplasty when clinically indicated, usually in older patients with primary impingement.

Acromion↗

PubMedDate not supplied

The effects of overuse combined with intrinsic or extrinsic alterations in an animal model of rotator cuff tendinosis.

An in vivo animal model was used to evaluate overuse and overuse plus intrinsic tendon injury or extrinsic tendon compression in the development of rotator cuff injury. Forty-four male Sprague-Dawley rats were divided into groups of 22. Each left shoulder received an intrinsic or extrinsic injury plus overuse (treadmill running), and each right shoulder received only overuse. Eleven rats from each group were sacrificed at 4 and 8 weeks. Supraspinatus tendons were evaluated histologically or geometrically and biomechanically. Ten rats constituted a cage-activity control group. Both supraspinatus tendons of the experimental groups had increases in cellularity and collagen disorganization and changes in cell shape compared with control tendons. Tendons with injury plus overuse exhibited a worse histologic grade than those with overuse alone. The cross-sectional area of both supraspinatus tendons of the experimental rats was significantly more than in control tendons. The area of the injury plus overuse tendons was increased on average compared with overuse-alone tendons. Biomechanically, the tissue moduli of overuse/intrinsic injury tendons at 4 weeks and those of the overuse/extrinsic injury tendons at 8 weeks were significantly lower than in control tendons. Tissue moduli of the overuse/injury tendons were significantly lower than in the overuse-alone tendons at 8 weeks. This study demonstrated that damage to the supraspinatus tendon can be caused by overuse and intrinsic injury, overuse and extrinsic compression, and overuse alone.

Animals↗

PubMedDate not supplied

Neer Award 1999. Overuse activity injures the supraspinatus tendon in an animal model: a histologic and biomechanical study.

Overuse activity has been implicated as an etiologic factor in injury to the rotator cuff and to the supraspinatus tendon in particular. Due in part to the lack of an appropriate animal model, expex85ental studies have not addressed this issue. With the use of a rat model, we measured the effects of an overuse running regimen on 36 Sprague-Dawley rats after 4 (n = 12), 8 (n = 12), or 16 (n = 12) weeks of exercise and compared them with a control group of rats (n = 10) who were allowed normal cage activity. The histologic characteristics, the gross morphologic characteristics, and the mechanical properties of the tendon tissue were evaluated. The supraspinatus tendons in the exercised animals demonstrated significant changes as a result of overuse at all time points compared with the normal group. There was an increase in cellularity and a loss of the normal collagen fiber organization consistent with what has been seen in human tendinopathy. The tendons from the exercise groups were larger than normal in cross-sectional analysis at 4 weeks (129% of control, P < .01) and continued to increase in size with time to 16 weeks (164% of control, P = .01). The mechanical properties of the tendons deteriorated in response to overuse exercise with a decreased modulus of elasticity ranging from 52% to 61% of control (P = .07 at 4 weeks, P < .05 at 8 and 16 weeks) and a decreased maximum stress of failure ranging from 51% to 63% of control (P < .007). These findings support overuse activity as an etiologic factor in the development of supraspinatus tendinopathy and begin to describe the changes in the tendons as a result of such activity. This model can now be used to study the effect of various treatment modalities on these injuries.

Animals↗