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PubMed2004

Bilateral accommodations to anterior cruciate ligament deficiency and surgery.

UNLABELLED: OBJECTIVE To determine bilateral lower extremity joint accommodations during gait in anterior cruciate ligament deficient subjects and uninjured controls. DESIGN: Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and 3 months following reconstructive surgery, and 10 uninjured controls. BACKGROUND: It is possible that bilateral joint accommodations could occur as a result of anterior cruciate ligament injury and in response to surgical repair. Few studies have investigated bilateral joint accommodations to anterior cruciate ligament injury and there is little consistency in the reported results. METHODS: Bilateral lower extremity kinematic and kinetic data were collected from 12 walking trials and inverse dynamics calculations were made to estimate bilateral knee and hip joint angle, moment, and power patterns during the stance phase of gait. RESULTS: Control subjects exhibited asymmetrical hip but symmetrical knee joint moment and power patterns. In contrast, the anterior cruciate ligament deficient subjects exhibited symmetrical hip and asymmetrical knee joint moment and power patterns prior to and following reconstructive surgery. CONCLUSIONS: Gait asymmetry in healthy subjects should not be considered pathological. In addition, chronic anterior cruciate ligament injury results in joint specific, bilateral lower extremity accommodations in gait mechanics. These accommodations persist 3 months following surgical repair.

Adaptation, Physiological↗
PubMed2006

Dynamic measurement of patellofemoral contact pressure following reconstruction of the medial patellofemoral ligament: an in vitro study.

BACKGROUND: Surgical reconstruction of the medial patellofemoral ligament used to stabilize the patella against lateral dislocation may concomitantly produce alteration of the patellofemoral contact pressure distribution. Two different tendon transfer techniques of reconstructing the medial patellofemoral ligament, one dynamic and one static, as well as a proximal soft tissue realignment of the patella were investigated. METHODS: Eight human knee specimens were mounted in a kinematic knee simulator and isokinetic extension motion was simulated. Patellofemoral pressure was measured using a pressure sensitive film while a 100 N laterally directed dislocation load was applied to the patella. The specimens were evaluated in a physiologic state, as well as after dynamic reconstruction of the medial patellofemoral ligament using a distal transfer of the semitendinosus tendon, following static reconstruction using a semitendinosus autograft, and following proximal soft tissue realignment of the patella. FINDINGS: Following both reconstruction techniques of the medial patellofemoral ligament patellofemoral contact pressure was not significantly (P=0.49) altered. In contrast, after proximal realignment a trend (P=0.07) towards higher contact pressure near knee extension was observed. In the absence of a lateral dislocation load dynamic and static reconstruction resulted in a medialization (P=0.04) of the center of pressure, whereas under the application of a 100 N dislocation load the center of pressure showed no significant alteration. Following proximal realignment the center of pressure was significantly medialized without (P<0.01) and with a dislocation load (P=0.01) throughout the entire range of knee motion. INTERPRETATION: Static and dynamic ligament reconstruction of the medial patellofemoral ligament did not alter patellofemoral pressure. Proximal realignment, on the other hand, resulted in a constant medialization of the patellofemoral pressure. The data suggest that the reconstruction techniques would be associated with a low risk of causing premature cartilage degeneration due to excessive patellofemoral contact pressure, whereas proximal realignment could cause medial overload of the patellofemoral joint.

Aged↗
PubMed2006

Vibration testing of a fresh-frozen human pelvis: the role of the pelvic ligaments.

A biodynamic model of the human pelvis is being developed in the frame of a research project on low back pain. In order to validate such model, the dynamic behaviour of the human pelvis needs to be investigated. In this study, a human fresh-frozen specimen comprising the three bones of the pelvic girdle and its ligamentous system has been used to perform vibration testing. In such test the response of the system to vibrations is measured at various points on the structure for frequencies between 10 and 340 Hz. The vibration testing is performed a first time on the specimen with intact ligamentous system. The measurements are taken two more times after subsequent bilateral resection of both the sacrotuberous and the sacrospinous ligaments first, and the iliolumbar ligaments afterwards. A comparison between the system response obtained in the three configurations provides information on the role of the resected ligaments in the dynamics of the system, thus on their relevance in the model. Results indicate that the sacrospinous, the sacrotuberous and the iliolumbar ligaments do not play a role in the pelvis dynamics as measured in this study, and will therefore not be represented in the biodynamic model.

Cryopreservation↗
PubMed2005

Carpal ligament injuries with acute scaphoid fractures - a combined wrist injury.

Fifty-two consecutive patients with acute scaphoid fractures were treated by closed reduction and percutaneous screw fixation. In addition, all underwent a wrist arthrogram and 22 patients also underwent a wrist arthroscopy. Eighteen patients (34%) had an associated carpal ligament injury (four scapholunate ligament, eight lunotriquetral ligament, two combined, three TFCC and one minor leak from the distal carpal row). These patients had worse Mayo wrist scores (no ligament injury median score=95: ligament injury median score=85) at a mean final follow-up of 61 weeks. We advocate that scaphoid fractures with associated carpal ligament injuries should be defined as a combined wrist injury.

Adolescent↗
PubMedDate not supplied

Posterior olecranon resection and ulnar collateral ligament strain.

Valgus extension overload is well described in the throwing athlete. The surgical treatment involves posterior olecranon osteophyte resection. It is not known how much of the posterior olecranon can be resected before increased stress is placed on the ulnar collateral ligament. Ten cadaveric arms underwent posterior olecranon resection in 4-mm increments. After each bone resection, three different valgus loads were applied to the elbow at 70 degrees and 90 degrees of flexion. Ulnar collateral ligament strain significantly increased with each load. Significantly more strain occurred on the ulnar collateral ligament at 90 degrees compared with 70 degrees of elbow flexion. This difference may be the result of the relative importance of the ulnar collateral ligament and the posterior olecranon at different positions of elbow flexion. The strain on the ulnar collateral ligament was slightly higher after the 8-mm and 12-mm cuts but not statistically significant. This study suggests that at moderate quasistatic valgus loads, ulnar collateral ligament strain is not significantly increased with posterior olecranon resection.

Adult↗
PubMed2004

[Should we divide Osborn's ligament during epicondylectomy and in situ decompression of the ulnar nerve?].

INTRODUCTION: Two groups of patients with cubital tunnel syndrome were treated by neurolysis and medial epicondylectomy. In the first group, the operative procedure consisted solely of dividing Osborn's ligament and fascia but in the second group Osborn's ligament was reinserted after epicondylectomy to avoid dislocation of the nerve. The aim of this retrospective study was to compare the level of complete recovery after surgery and the frequency of dislocation of the nerve. MATERIAL AND METHOD: Group one: Nineteen patients, with a mean age of 47.7 (15-65), and 52% female, with the dominant hand involved in 63% cases, were treated. According to Mac Gowan's criteria, 32% of the elbows were classified preoperatively as grade I, 52% as grade II and 16% as grade III. Sensory nerve conduction velocity across the elbow was less than 40 m/s in 40% of cases. The mean duration of the disease was longer than 3 years in 16% of cases. Group two: Twenty three patients, with a mean age of 54.1 (33-75), and 56% female, with the dominant hand involved in 56% cases, were treated. According to Mac Gowan's criteria, three 17% of the elbows were classified preoperatively as grade I, 47% as grade II and 34% as grade III. Sensory nerve conduction velocity across the elbow was less than 40 m/s in 60% of cases. The mean duration of the disease was longer than 3 years in 4% of cases. Both groups were evaluated by a surgeon not involved in the treatment by clinical examination and DASH scoring. RESULTS: DASH scoring is correlated with functional recovery, grip strength and Mac Gowan preoperative scoring. In group one, (divided and reinserted ligament) with younger patients, half the incidence of Mac Gowan stage II and a shorter follow up, there were no dislocations, but less complete resolution of preoperative symptoms (68%/82%) and a higher DASH scoring (30.6/24.9). In group two (resected ligament), dislocation of the nerve was noted in 17% of cases. In both groups, pain at the epicondylectomy site was noted in 20% of cases. The chance of complete recovery was inversely related to the age (>50), and to the duration of the disease (>1 year). DISCUSSION: Surgical treatment of ulnar nerve entrapment at the elbow remains controversial. None of the presently advocated procedures (simple decompression of the ulnar nerve, medial epicondylectomy or transposition of the ulnar nerve) has proven optimal regarding long-term results. In both groups in this study, neurolysis of ulnar nerve by section of Osborn's ligament and fascia together with medial epicondylectomy proved to be an effective surgical procedure for treating grade I to II ulnar neuropathy. Section of Osborn's ligament without its reattachment is followed by more cases of complete recovery as well as more dislocation of the nerve although the latter elicited no subjective complaints from the patients. DASH scoring is effective in evaluating the recovery.

Adolescent↗
PubMed2004

The combined regulation of estrogen and cyclic tension on fibroblast biosynthesis derived from anterior cruciate ligament.

Female athletes are two to eight times more likely to suffer a knee or ankle ligament injury than male athletes, and sex hormones have been considered to play an important role in the injury. Because ligaments are always under mechanical loading during sports, mechanical force is also a critical factor in ligament injuries. In this study, the effects of estrogen and mechanical loading on the gene expression of three major components of ligament--collagen type I, type III, and biglycan--in primary cultured porcine anterior cruciate ligament (ACL) fibroblasts were investigated individually and collectively using reverse transcript-polymerase chain reaction (RT-PCR). The results revealed that cyclic tensile loading alone increased the messenger RNA expression of collagen I but did not affect that of collagen III and biglycan, and estrogen alone increased the gene expression of collagen I and III but not of biglycan. However, combined administration of estrogen and cyclic loading inhibited the mRNA expression of all the three genes. These results suggested that the inhibition of the gene expression of major extracellular matrix component molecules caused by the combined effects of estrogen and mechanical loading, unique to females, might be responsible for the increased incidence of ligaments injury in female athletes.

Animals↗
PubMed1998

The risk of cystocele after sacrospinous ligament fixation.

OBJECTIVE: The aim of this study was to determine whether sacrospinous ligament fixation independently increases the risk of anterior vaginal wall defect. STUDY DESIGN: A retrospective cohort study was conducted on patients undergoing pelvic reconstructive surgical operations by a single surgeon from 1970 through 1997. Two groups were examined and divided into subgroups to evaluate the effects of exposure to sacrospinous ligament fixation: patients with anterior wall defects undergoing standard anterior colporrhaphy with (group 1A) or without (group 1B) concomitant sacrospinous ligament fixation, and patients without anterior wall defects undergoing other pelvic reconstructive procedures (but not anterior colporrhaphy) with (group 2A) or without (group 2B) sacrospinous ligament fixation. Recurrence rates were calculated for each group according to evidence of any degree of anatomic defect. RESULTS: Among 322 patients in group 1, 9 of 77 in group 1A and 23 of 245 in group 1B (11.7% vs 9.4%, P >.05) had anterior wall recurrences. Among 73 patients in group 2, 8 of 45 in group 2A and 5 of 28 in group 2B (17.8% vs 17.9%, P >.05) had subsequent anterior wall defects. CONCLUSION: The occurrence of anterior vaginal wall defects was not found to be altered by the performance of sacrospinous ligament fixation. These findings may be attributable to surgical technique emphasizing maintenance of anterior vaginal wall length during sacrospinous ligament fixation.

Aged↗
PubMed1999

Blood volume in human bicuspid periodontal ligament determined by electron microscopy.

The microvascular volume of periodontal ligament is reported to range from 1.63 to 3.5% in man, whereas that of animals varies from 7.5 to 11.5%. This transmission electron-microscopic investigation was undertaken to determine stereologically the volume in human periodontal ligament. The hypothesis tested was that the ligament blood volume in man is similar to that in animals. Left and right segments of mandible containing first and second premolars came from an adult burns' victim who underwent jaw reconstruction. The segments were immersion-fixed in 2.5% glutaraldehyde, demineralized at 4 degrees C in 0.1 M EDTA and processed for microscopy. Segments of distal periodontal ligament were sectioned at 150-micron intervals from the alveolar crest to the root apex and random tissue quadrats recorded for point counting and data analysis using a generalized linear-regression statistical model. Mean adjusted microvascular luminal volume was 9.52 +/- 2.28% (SEM) and the abluminal volume 12.91 +/- 2.76%; the wall volume was 3.39%. Significant differences existed between the luminal and abluminal volumes of the different vessel type (p < 0.05) and their distribution across the circumferential thirds of the ligament (p < 0.05). Total length density of the blood vessels was 149.84 x 10(3) cm/cm3 and the surface density 330.19 cm2/cm3. Postcapillary-sized venules held 69.1% of the total blood volume and provided 49.3% of the luminal surface area. Venous capillaries were the most common vessel, comprising 48.5%, and they contributed 71.5% of the overall length density. This study confirmed the hypothesis for the blood volume in the periodontal ligament in man. Blood volumes do not reflect the configurations of microvascular beds.

Adult↗
PubMed1996

Lower extremity injuries in college athletes: relation between ligamentous laxity and lower extremity muscle tightness.

OBJECTIVE: Two components of flexibility, muscle tightness, and ligamentous laxity in college athletes were studied to determine whether these factors were associated with the incidence of lower extremity injuries. DESIGN: Prospective cohort study. SETTING: College athletic department. PARTICIPANTS: 201 college athletes. OUTCOME MEASURES: College men and women athletes were tested for ligamentous laxity with the Beighton scale and for muscle tightness with a new scale based on the tightness of the iliopsoas, iliotibial band, hamstring, rectus femoris, and gastrocsoleus muscles. Lower extremity injuries incurred during practice and play were recorded during the following year. RESULTS: Of the 201 athletes tested, 71 sustained 115 injuries. For each additional point on the 9-point ligamentous laxity scale (9 = hyperlax), the risk of injury decreased 16%. For each additional point on the 10-point muscle-tightness scale (10 = all muscles tight), the risk of injury increased 23%. The two scores were moderately inversely correlated (Spearman's rho = -0.3; p < .001). Women had greater mean (+/- SD) laxity scores than men (3.3 +/- 2.2 vs. 1.8 +/- 2.0; p < .001) and lower mean overall muscle tightness scores (1.5 +/- 1.6 vs. 3.5 +/- 2.1; p < .001). Among Women athletes, the rate of lower extremity injury was unrelated to ligamentous laxity or to flexibility. Among men, lower extremity injuries were associated with lower ligamentous laxity scores (p = .008) and greater muscle tightness (p = .04). CONCLUSIONS: This study introduces a new scale for lower extremity muscle tightness. Tight ligaments and muscles are related to injury in men, but not women, college athletes. A preseason flexibility program may decrease injuries in college men athletes.

Adult↗
PubMed1998

The difference in anatomy of the lumbar anterior longitudinal ligament in young African-Americans and Scandinavians.

OBJECTIVE: To examine possible structural differences in the lumbar anterior longitudinal ligament between young African-American and Scandinavian people. DESIGN: The lumbar anterior longitudinal ligament was examined in 48 African-American and Scandinavian young men and women (17 to 30 years old). Apart from the selection of gender, age, height, and weight, all subjects were recruited consecutively during routine forensic autopsies. Sections of the ligament were obtained from the L1 and the L5 vertebra for thickness and width measurements and histologic preparations. The measurements were performed with a digital vernier caliper with an accuracy of 0.1 mm. RESULTS: The width of the L1 part of the lumbar anterior longitudinal ligament in the African-American group (27.5+/-1.8mm) was greater than that in the Scandinavian group (17.7+/-1.5mm) (p < .001), and the thickness of the L1 part in the African-American group (3.8+/-0.4mm) was greater than that in the Scandinavian group (3.3+/-0.3mm) (p < .001). The width of the L5 part in the African-American group (34.1+/-2.0mm) was greater than that in the Scandinavian group (25.0+/-1.5mm) (p < .001), and the thickness of the L5 part in the African-American group (3.3+/-0.3mm) was greater than that in the Scandinavian group (2.2+/-0.3mm) (p < .001). The cross-sectional area was greater in the African-American group in both sections (L1, African-American 106.4+/-13.7mm2 vs Scandinavian 52.8+/-7.9mm2; L5, African-American 112.2+/-14.6mm2 vs Scandinavian 55.6+/-6.7mm2) (p < .001). No histologic differences between the two groups were observed. CONCLUSIONS: The lumbar anterior longitudinal ligament was considerably wider and thicker, which yielded a markedly greater cross-sectional area, in African-American than in Scandinavian subjects. In contrast, the ligament appears to be histologically similar in the two groups. These are previously unrecognized differences in anatomy between young African-American and Scandinavian people.

Adolescent↗
PubMed2000

Collagen fibril D-period may change as a function of strain and location in ligament.

The purpose of this study was to determine if the characteristic banding pattern (D-period) of collagen fibrils from rabbit medial collateral ligaments changes as a function of gross ligament strain and, if so, whether the changes are location dependent (insertion versus midsubstance). Femur-medial collateral ligament-tibia complexes were strained to 0, 8, or 12% and immediately chemically fixed in situ. Samples were taken from the medial collateral ligament midsubstance and bony insertions, and prepared for and observed under a transmission electron microscope. D-period length was measured and found to increase (albeit not significantly so, p=0. 1) as a function of gross strain for samples obtained from the insertion sites but not for samples obtained from the ligament midsubstance. Results suggested that ligament strains are inhomogeneous at the ultrastructural level.

Animals↗
PubMed1997

Estrogen and progesterone receptors in the uterosacral ligament.

OBJECTIVE: To evaluate steroid hormone receptor status in the uterosacral ligament, a structure that contributes to pelvic support. METHODS: A descriptive study was conducted by sampling the uterosacral ligaments from 25 consecutive women undergoing hysterectomy by the primary author for nonmalignant conditions. Using immunohistochemical staining techniques, uterosacral ligaments were assessed for the presence and location of estrogen and progesterone receptors. Positive and negative controls were used. Confirmation of the uterosacral ligament was performed histologically. RESULTS: Using commercially available monoclonal antibodies, estrogen and progesterone receptors were detected in the nuclei of smooth muscle cells of the uterosacral ligament in all patients, regardless of variations in age, race, menopausal status, parity, body mass index, and medications affecting serum steroid hormone levels. Hormone receptors were not found in the collagen, vascular, or neuronal components. CONCLUSION: The presence of estrogen and progesterone receptors in the uterosacral ligaments means that this structure may be a target for estrogen and progesterone. This finding might suggest a possible role for steroid hormones in pelvic support.

Adnexa Uteri↗
PubMed2001

Risk of recurrent stress incontinence in women undergoing the combined modified pereyra procedure and transvaginal sacrospinous ligament vault suspension.

OBJECTIVES: To determine the risk of recurrent stress urinary incontinence in women undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension. METHODS: A retrospective analysis of 62 patients who underwent the modified Pereyra procedure at Harbor-UCLA Medical Center between October 1, 1993 and July 10, 1999 for stress urinary incontinence was performed. RESULTS: The study group consisted of 62 patients treated for stress incontinence; 34 (55%) of the 62 patients underwent the modified Pereyra procedure for stress incontinence, and 28 (45%) underwent the combined modified Pereyra procedure and sacrospinous ligament vault suspension for stress incontinence and coexistent uterine and/or vaginal vault prolapse. Patients undergoing the modified Pereyra procedure without vaginal vault suspension had higher subjective (91% versus 64%, P = 0.01) and objective (88% versus 61%, P = 0.02) cure rates of stress urinary incontinence compared with the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension. The mean follow-up period for the patients undergoing the modified Pereyra procedure (23 +/- 14.4 months) was similar to that of the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension (26 +/- 9.4 months) (P = 0.3). Compared with the objectively cured patients, patients with objective failure demonstrated postoperative bladder neck hypermobility and a higher rate of recurrent grade 2 or greater anterior vaginal prolapse. Eleven patients had postoperative detrusor instability, and 2 patients who underwent sacrospinous ligament vault suspension developed recurrent grade 3 apical vault prolapse. CONCLUSIONS: Patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension have high rates of recurrent stress urinary incontinence.

Combined Modality Therapy↗
PubMed1998

Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy.

OBJECTIVES: To determine whether a puboprostatic ligament-sparing technique of prostatic apical dissection provided improved urinary continence after radical retropubic prostatectomy. METHODS: A total of 43 men with clinically localized prostate cancer underwent radical retropubic prostatectomy (standard apical dissection in 25, puboprostatic ligament-sparing technique in 18). Patients were evaluated by independent observer questionnaire to determine their continence status. The questionnaire was tested in a control group of 25 men who had not undergone prostate surgery. The overall continence rate and time to achieve continence was compared between the two surgical groups. In addition, the clinical and pathologic stages and both the rate and location of positive margins were assessed. RESULTS: Mean patient age and serum prostate-specific antigen values were not significantly different between the two groups. Clinical and pathologic stages were also similar. The mean follow-up period for the puboprostatic ligament-sparing group was 35 weeks compared with 57 weeks for the standard group (P < 0.05). The median time until continence was achieved after surgery was significantly shorter (P = 0.01) for the puboprostatic ligament-sparing group than for the standard method (6.5 and 12 weeks, respectively). However, the overall continence rate at 1-year follow-up for the two groups was similar (100% and 94%, respectively). The positive margin rate and location of positive margins were not different with the puboprostatic ligament-sparing technique. CONCLUSIONS: The puboprostatic ligament-sparing technique improves the rapidity of return of urinary continence after radical prostatectomy without significantly enhancing overall continence or interfering with the therapeutic efficacy of the procedure.

Adenocarcinoma↗
PubMed2004

MR imaging of thumb carpometacarpal joint ligament injuries.

This study describes the MR imaging appearances of the supporting ligaments of the thumb carpometacarpal joint in asymptomatic volunteers and in a group of patients following joint injury. Fourteen patients with 11 acute and three chronic injuries underwent MR imaging. The anterior oblique ligament was the most commonly injured ligament, usually on the metacarpal side where it was disrupted, or allowed dislocation because of subperiosted stripping from the base of the thumb metacarpal. The dorsal radial ligament was occasionally avulsed or partially torn from the trapezoid. Following chronic injury, MR imaging can evaluate ligamentous laxity, ganglion cyst formation or osteoarthritis. Accurate evaluation of ligament injury may identify patients who would benefit from surgery.

Adult↗
PubMed1985

Volar intercalated segment instability as a result of spontaneous rupture of the supporting ligaments of the wrist due to longterm systemic steroid medication.

Linscheid and Dobyns (1972), in a classical article on post-traumatic instability of the wrist described two major types of instability, dorsal and volar. The dorsal intercalated segment instability (D.I.S.I.) was the more common and occurred with scapholunate dissociation and displaced scaphoid fractures. The instability occurred in these conditions as a result of the scaphoid losing its ability to support the carpus. They presented five cases of volar intercalated segment instability (V.I.S.I.) of which four were related to congenital ligament laxity and not to traumatic ligament disruption. In the one case of traumatic origin they felt that the capitolunate ligament was ruptured. However, more recent publications by Taleisnik, Prietto (1982) and Reagan, (1984) have proposed that for V.I.S.I. to occur the lunate triquetral interosseous ligament must be disrupted. We report this case as it demonstrates which ligamentous structures are torn for V.I.S.I. to occur. In addition, these ligament disruptions were pathological and occurred spontaneously as a result of longterm systemic steroid medication.

Aged↗
PubMed1999

Age related biomechanical properties of the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex.

OBJECTIVE: To quantify the biomechanical properties of the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex for the two age groups. DESIGN: In vitro human cadaver study evaluating the biomechanical properties of the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex for a younger group (n=5, mean age 38.5, SD 0.5 years) and an older group (n=7, mean age 74.8, SD 5.3 years). BACKGROUND: Glenohumeral instability is more of a problem in younger than in older individuals, primarily because recurrence is much more common at a young age. METHODS: Tensile testing was performed on the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex in the shoulder apprehension position using a custom jig, Instron machine and a video digitizing system. RESULTS: In the younger individuals disruption of the complex most often occurred at the glenoid-labrum region of the glenoid insertion site. In the older individual, disruption most often occurred at the midsubstance region. The load and the stress at failure of the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex showed that the older group was only 61% and 46% of the younger group, respectively. CONCLUSIONS: The structural properties of the glenoid-anterior band of the inferior glenohumeral ligament-humerus complex and the material characteristics of the anterior band of the inferior glenohumeral ligament for the younger group were significantly superior than the older group. RELEVANCE: A stronger and more extensive repair, such as the traditional open technique, may be necessary for younger individuals with glenohumeral instability whereas in older individuals, a different repair technique, such as an arthroscopic technique, may be sufficient.

Adult↗