Moreover an isokinetic examination was done with the Cybex dynamometer. In gener- al, the superior and anterosuperior parts of the labrum have less vascularity than do the posterosuperior and inferior parts, and the vascularity is limited to the pe- riphery of the labrum. The current authors review the anatomy, classification, presentation, evaluation and treatment results of superior labrum anterior and posterior lesions, and includes novel evaluation methods and treatment guidelines useful in treating these lesions. The Click-phenomenon reached the highest sensitivity of all tests with 92%. Aufgrund der Trägheit der bestehenden Systeme ist zudem die Schnellkraft häufig schlecht trainierbar. We studied the gross, histological, and vascular anatomy of the glenoid labrum in twenty-three fresh-frozen shoulders from cadavera to demonstrate its cross-sectional anatomy, its microvascularity, and its at- tachments.
It is also connected to the joint capsule and the integrated ligaments. Er ging bei seinen Überlegungen davon aus, daß beim herkömmlichen auxotonischen Training die Komponente Widerstand konstant oder nur unspezifisch variiert wird, der Krafteinsatz innerhalb des Bewegungsradius sich aber verändert. A clear appreciation for the various lesions and the potential resulting joint dysfunction is necessary to determine the appropriate treatment of this complex region of the shoulder. The results of biceps reinsertion are disappointing compared with biceps tenodesis. Search below to view digital records and find material that you can access at our library and at the Shapell Center. The literature describes various strategies for imaging and treating these biceps tendon complex injuries but offers no clear consensus on a gold-standard approach. Presenting symptoms often are nonspecific and physical examination maneuvers have varying degrees of sensitivity and specificity making diagnosis challenging.
Diagnostic ability is enhanced by the ultimate diagnostic test, arthroscopy. In addition, they performed a 50-contraction endurance trial at 240° in both positions. The high values of sensitivity und specifity puplished in the original articles could not be confirmed. The keys to successful treatment are an accurate diagnosis, identification of associated pathologic conditions, and assessment of functional limitations of the injury. The glenoid labrum consists of circularly arranged collagenous fibers attached to the osseous margin of the glenoid by a fibrocartilaginous transitional zone.
As the age of the 2 treatment groups differed, these findings should be confirmed by future studies. The overhead athletes achieved the highest values in all isokinetic measurements. Vessels supplying the labrum originate from either capsular or periosteal vessels and not from the underlying bone. The purpose of this study was to evaluate the clinical tests. This reference provides text, photographs, charts, maps, and extensive indexes.
In particular, the differentiation between the normal and pathological adherence of the labrum is a serious clinical problem. The superior and anterosuperior portions of the labrum are loosely attached to the glenoid, and the macro-anatomy ofthose portions is similar to that of the meniscus of the knee. The purpose of this study was to demonstrate the anatomy, vascularity, and regional variations in the morphology of the glenoid labrum. Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded. Various injury mechanisms have been suggested and studied and it is likely that different mechanisms produce different types and areas of damage to the superior labrum.
The arteries supplying the periphery of the glenoid labrum come from the suprascapular, circumflex scapu- lar, and posterior circumflex humeral arteries. Cohort study; Level of evidence, 3. Eine Gelenkeinheit wird somit in ihren schwächsten Bereichen schnell überlastet, in ihren stärksten Bereichen aber unterbelastet. These additional online resources from the U. Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner. Proximal biceps tendon rupture, biceps tendinitis, and medical biceps subluxation are injuries that occur alone and in association with other pathologic conditions of the shoulder. .
Fifteen patients 9 men and 6 women with an average age of 52 years range, 28-64 underwent arthroscopic biceps tenodesis performed with an absorbable interference screw. In up to 18% of the patients normal clefts can be seen, e. Advancements in shoulder arthroscopy have led to a better understanding of the anatomy and disorders of the superior labrum biceps tendon anchor complex and the role that lesions of the superior labrum anterior and posterior lesions play in pain and instability of the shoulder. The superior portion of the la- brum also consistently inserts directly into the biceps tendon, while its inferior portion is firmly attached to the glenoid rim and appears as a fibrous, immobile extension of the articular cartilage. It consists mostly of fibrous tissue rather than cartilagettt6, and damage to the glenoid labrum, with or without cap- sular injury,has been clearly implicated in the pathophys- iology of instability of the shouldertlTt6.
It is suggested that while testing swimmers, the prone position be used to obtain the highest strength and endurance values. Holocaust Memorial Museum will help you learn more about the Holocaust and research your family history. Classification systems have been proposed to describe the specific pathoanatomy of lesions of the superior labrum anterior and posterior lesions and to guide treatment. The cranial part of the labrum is more compact than the caudal one. Most of the fibers of the long head of the biceps tendon insert at the supraglenoid tubercle, only some of them continue in the fibrous ring.