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Does the glenohumeral joint capsule have proprioceptive capability?

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

We performed a clinical study examining 60 volunteers with stable shoulder joints randomized to two groups. In group 1 we injected 5 ml lidocaine intra-articularly. In group 2 we injected 5 ml saline with 5 ml contrast dye the same way. After the injection we measured the amount of passive anteroposterior translation that occurred during anterior and posterior drawer tests and the amount of inferior subluxation during downward stress. We documented the extent of the passive glenohumeral translation using ultrasound. We had no complications related to the intra-articular injection or to the stability measurement. After the injection neither group had significant pain, and the patients were not apprehensive about the ensuing stability test. In group 1 (lidocaine) anteroposterior translation of 13.2±6.3 mm was seen in the anterior and posterior drawer test, whereas in group 2 (no lidocaine) the anteroposterior translation was only 6.8±3.2 mm. The difference between the two groups was statistically significant (P<0.05). With downward stress during the sulcus test the distance between the acromion and the humeral head increased by 5.6 mm (±3.2) in group 1 and by 2.7 mm (±2.1) in group 2. This difference was also statistically significant (P<0.05).Clinical consequences: Taking our preliminary findings into account, the capsule of the glenohumeral joint seems to have proprioceptive capability. Nerve fibres and mechanoreceptors seem to be localized in the capsule tissue, being part of a physiological feedback mechanism. If our conclusions proprioceptive capability. Nerve fibres and mechanoreceptors seem to be localized in the capsule tissue, being part of a physiological feedback mechanism. If our conclusions turn out to be right, patients with labrum detachment after traumatic shoulder dislocation should undergo surgery as soon as possible to restore their anatomical integrity and retain the neurophysiological feedback mechanism.

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References

  1. Baker CL, Uribe JW, Whitman C (1990) Arthroscopic evaluation of acute initial anterior shoulder dislocation. Am J Sports Med 18: 25–28

    PubMed  Google Scholar 

  2. Bankart ASB (1923) Recurrent or habitual dislocation of the shoulder joint. Br Med J 2: 23–29

    Google Scholar 

  3. Bankart ASB (1938) Pathology and treatment of recurrent dislocation of shoulder-joint. Br J Surg 26: 23–29

    Google Scholar 

  4. Blazina E, Satzman JS (1969) Recurrent anterior subluxation of the shoulder in athletics. J Bone Joint Surg [Am] 51: 1037–1038

    Google Scholar 

  5. Boyd IA (1954) The histological structure of the receptors in the knee joint of the cat correlated with their physiological response. J Physiol (Lond) 124: 476–488

    Google Scholar 

  6. Brewer BJ, Wubben RC, Carrera GF (1986) Excessive retroversion of the glenoid cavity. A cause of non-traumatic posterior instability of the shoulder. J Bone Joint Surg [Am] 68: 721–731

    Google Scholar 

  7. Broca A, Hartmann H (1890) Contribution à l'étude des luxations de l'épaule. Bull Soc Anat Paris 4: 312–336, 416–423

    Google Scholar 

  8. Burgess PR, Clarke FJ (1969) Characteristics of the knee joint receptors in the cat. J Physiol (Lond) 203: 317–335

    Google Scholar 

  9. Caird FM (1887) The shoulder joint in relation to certain dislocations and fractures. Edinb Med J 32: 708–714

    Google Scholar 

  10. Cyprien JM, Vasey HM, Burdet A (1983) Humeral retrotorsion and the glenohumeral relationship in the normal shoulder and in recurrent anterior dislocation. Clin Orthop 175: 8–17

    PubMed  Google Scholar 

  11. Delorme D (1910) Die Hemmungsbänder des Schultergelenks und ihre Bedeutung für die Schulterluxation. Arch Klin Chir 92: 79–101

    Google Scholar 

  12. DePalma AF (1983) Surgery of the shoulder, 3rd edn. Lippincott, Philadelphia

    Google Scholar 

  13. Detrisiac DA, Johnson LL (1986) Arthroscopic shoulder anatomy. Slack, New Jersey

    Google Scholar 

  14. Ecklund G, Skoglund S (1970) On the specificity of the Ruffini like joint receptors. Arch Physiol Scand 49: 184–191

    Google Scholar 

  15. Fick R (1904) Handbuch der Anatomie und Mechanik der Gelenke unter Berücksichtigung der bewegenden Muskeln. Fischer, Jena

    Google Scholar 

  16. Flood V (1829) Discovery of a new ligament of the shoulder joint. Lancet 1: 672–673

    Google Scholar 

  17. Flower WH (1861) On pathologic changes produced in the shoulder by traumatic dislocation. Trans Pathol Soc Lond 12: 179–200

    Google Scholar 

  18. Freeman MAR, Wyke BD (1964) Articular contribution to limb muscle reflexes. I. An electromyographic study of the ankle joint mechanoreceptors upon reflex activity in the gastroenemius muscle of the cat. J Physiol (Lond) 171: 20–21

    Google Scholar 

  19. Freeman MAR, Wyke BD (1967) The innervation of the knee joint: an anatomical and histological study in the cat. J Anat 101: 505–532

    PubMed  Google Scholar 

  20. Habermever P, Wiedemann E, Kreusser T, Brunner U, Kaiser E (1985) Anatomical and electrophysiological evaluation of stabilising mechanism of the long head of the biceps brachii. In: Refior HJ, Piltz W, Jäger M, Hackenbroch MM (eds) Biomechanik der gesunden und kranken Schuler. Thieme, Stuttgart, pp 66–70

    Google Scholar 

  21. Harryman DT, Slides JA, Harris SL, Matsen FA (1992) Laxity of the normal glenohumeral joint: a quantitative in vivo assessment. J Shoulder Elbow Surg 1: 66–76

    Google Scholar 

  22. Helmig P, Sojbjerg JO, Kjaersgaard-Andersen P, Nielsen S, Ovesen J (1990) Distal humeral migration as a component of multidirectional shoulder instability. Clin Orthop 252: 139–143

    PubMed  Google Scholar 

  23. Hilton J (1863) On the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and diagnostic value of pain. A Course of Lectures, Bell and Daldy, London

    Google Scholar 

  24. Hovelius L (1987) Anterior dislocation of the shoulder in teenagers and young adults. J Bone Joint Surg [Am] 69: 393–399

    Google Scholar 

  25. Hovelius L, Eriksson K, Fredin H, Hagberg G, Hussenius A, Lind B, Thorling J, Weckström J (1983) Recurrence after initial dislocation of the shoulder. J Bone Joint Surg [Am] 65: 343–348

    Google Scholar 

  26. Howell SM, Imobersteg AM, Seger DH, Maroned PJ (1986) Clarification of the role of the supraspinatus muscle in shoulder function. J Bone Joint Surg [Am] 68: 398–404

    Google Scholar 

  27. Inman VT, Saunders JC, Abott LC (1944) Observations of the function of the shoulder joint. J Bone Joint Surg [Am] 26: 1

    Google Scholar 

  28. Jerosch J (1992) Über die Funktion der passiven Stabilisatoren des glenohumeralen Gelenkes. In: Kohn D, Wirth CJ (eds) Die Schulter-Aktuelle operative Therapie. Thieme. Stuttgart, pp 2–15

    Google Scholar 

  29. Jerosch J, Marquardt M (1990) Sonographische Untersuchung zur AP-Translation des Humeruskopfes bei der aktiven Bewegung bei traumatischer anteriorer Schulterinstabilität. Z Orthop 128: 637–641

    PubMed  Google Scholar 

  30. Jerosch J, Marquardt M, Winkelmann W (1990) Der Stellenwert der Sonographie in der Beurteilung von Instabilitäten des glenohumeralen Gelenkes. Z Orthop 128: 41–45

    PubMed  Google Scholar 

  31. Jerosch J, Moersler M, Castro WHM (1990) Über die Funktion der passiven Stabilisatoren des glenohumeralen Gelenkes — Eine biomechanische Untersuchung. Z Orthop 128: 206–212

    PubMed  Google Scholar 

  32. Jerosch J, Clahsen H, Grosse-Hackmann A, Castro WHM (1992) Proprioceptive capability of the glenohumeral joint capsule — an anatomic and clinical study. First World Congress of Sports Trauma, 25–29 May 1992. Palma de Mallorea

  33. Jobe FW (1985) Unstable shoulders in athletes. Instr Course Lect 34: 228–231

    PubMed  Google Scholar 

  34. Johansson H, Sjölander P, Sojka P (1991) A sensory role for the cruciate ligaments. Clin Orthop 268: 161–178

    PubMed  Google Scholar 

  35. Kumar VP, Balsubramaniam P (1985) The role of atmospheric pressure in stabilizing the shoulder: An experimental study. J Bone Joint Surg [Br] 67: 719–721

    Google Scholar 

  36. Levick JR (1983) Joint pressure-volume studies: their importance, design and interpretation. J Rheumatol 10: 353–357

    PubMed  Google Scholar 

  37. Moseley HF, Övergaard B (1962) In anterior capsular mechanism in recurrent anterior dislocation of the shoulder. Morphological and clinical studies with special reference to the glenoid labrum and the glenohumeral ligament. J Bone Joint Surg [Br] 44: 913–927

    Google Scholar 

  38. Müller W (1929) Über den negativen Luftdruck im Gelenkraum. Dtsch A Chir 217: 395–401

    Google Scholar 

  39. Perry J (1983) Anatomy and biomechanics of the shoulder in throwing, swimning, gymnastics and tennis. Clin Sports Med 2: 247–270

    PubMed  Google Scholar 

  40. Perthes G (1906) Über Operationen bei habitueller Schulterluxation. Dtsch Z Chir 85: 199–227

    Google Scholar 

  41. Poppen NK, Walker PS (1978) Forces at the glenohumeral joint. Clin Orthop 135: 165–170

    PubMed  Google Scholar 

  42. Post M (1978) The shoulder — surgical and non-surgical treatment. Lea & Febiger, Philadelphia

    Google Scholar 

  43. Randelli M, Gambrioli PL (1986) Glenohumeral osteometry by computed tomography in normal and unstable shoulders. Clin Orthop 208: 151

    PubMed  Google Scholar 

  44. Rockwood CA, Matsen FA (1990) The shoulder, Saunders, Philadelphia

    Google Scholar 

  45. Rowe CR (1980) Acute and recurrent anterior dislocations of the shoulder. Orthop Clin North Am 11: 253–270

    PubMed  Google Scholar 

  46. Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term and end-result study. J Bone Joint Surg [Am] 60: 1–16

    Google Scholar 

  47. Saha AK (1971) Dynamic stability of the glenohumeral joint. Acta Orthop Scand 42: 491–505

    PubMed  Google Scholar 

  48. Saha AK (1973) Mechanics of elevation of glenohumeral joint. Acta Orthop Scand 44: 668

    PubMed  Google Scholar 

  49. Schlemm F (1985) Über die Verstärkungsbänder am Schultergelenk. Arch Anat 45–48

  50. Simoneit WT, Cofield RH (1984) Prognosis in anterior shoulder dislocation. Am J Sports Med 12: 19–24

    PubMed  Google Scholar 

  51. Skoglund S (1956) Anatomical and physiological studies of the knee joint innervation in the cat. Acta Physiol Scand 36 Suppl 124: 1–101

    Google Scholar 

  52. Townley CO (1950) The capsular mechanism in recurrent dislocation of the shoulder. J Bone Joint Surg [Am] 32-A: 370–380

    Google Scholar 

  53. Turkel SJ, Panio MW, Marshall JL, Girgis FG (1981) Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg [Am] 63: 1208–1217

    Google Scholar 

  54. Wheeler JH, Ryan JB, Arciero RA, Molinari RN (1989) Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy 5: 213–217

    PubMed  Google Scholar 

  55. Wyke BD (1973) Structural and functional characteristics of articular receptor system. Acta Chir Orthop Traumatol Cech 40: 489–497

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Orthopedic Department, Westfälische Wilhelms University, Albert-Schweitzer Strasse 33, D-48149, Münster, Germany

    J. Jerosch MD, W. H. M. Castro, H. Halm & H. Drescher

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  1. J. Jerosch MD
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  2. W. H. M. Castro
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  3. H. Halm
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  4. H. Drescher
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Jerosch, J., Castro, W.H.M., Halm, H. et al. Does the glenohumeral joint capsule have proprioceptive capability?. Knee Surg, Sports traumatol, Arthroscopy 1, 80–84 (1993). https://doi.org/10.1007/BF01565457

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