Bi-directional mechanical properties of the posterior region of the glenohumeral capsule

The objective of this study was to determine the mechanical properties of the posterior region of the glenohumeral capsule in the directions perpendicular (transverse) and parallel (longitudinal) to the longitudinal axis of the posterior band of the inferior glenohumeral ligament. A punch was used to excise one transverse and one longitudinal tissue sample from the posterior capsule of 11 cadaveric shoulders. All tissue samples exhibited the typical nonlinear behavior reported for ligaments and tendons. Significant differences (p < 0.05) were detected between the transverse and longitudinal tissue samples for ultimate stress (1.5+/-1.4 and 4.9+/-2.9 MPa, respectively) and tangent modulus (10.3+/-6.6 and 31.5+/-12.7 MPa, respectively). No significant differences (p > 0.05) were observed between the ultimate strain (transverse: 22.3+/-12.5%, longitudinal: 22.8+/-11.1%) and strain energy density (transverse: 27.2+/-52.8 MPa, longitudinal: 67.5+/-88.2 MPa) of the transverse and longitudinal tissue samples. The ratio of the longitudinal to transverse moduli (4.8+/-4.2) was similar to that found for the axillary pouch (3.3+/-2.8) in a previous study. Thus, both the axillary pouch and the posterior capsule function to stabilize the joint multi-axially. Future analytical models of the glenohumeral joint should consider the properties of the posterior capsule in its transverse and longitudinal directions to fully describe the behavior of the glenohumeral capsule. These models will be clinically important by providing a more accurate representation of the intact capsule as well as simulated capsular injuries and surgical repair procedures.     

Material characterization of human medial collateral ligament.

The objectives of this study were to determine the longitudinal and transverse material properties of the human medial collateral ligament (MCL) and to evaluate the ability of three existing constitutive models to describe the material behavior of MCL. Uniaxial test specimens were punched from ten human cadaveric MCLs and tensile tested along and transverse to the collagen fiber direction. Using load and optical strain analysis information, the tangent modulus, tensile strength and ultimate strain were determined. The material coefficients for each constitutive model were determined using nonlinear regression. All specimens failed within the substance of the tissue. Specimens tested along the collagen fiber direction exhibited the typical nonlinear behavior reported for ligaments. This behavior was absent from the stress-strain curves of the transverse specimens. The average tensile strength, ultimate strain, and tangent modulus for the longitudinal specimens was 38.6 +/- 4.8 MPa, 17.1 +/- 1.5 percent, and 332.2 +/- 58.3 MPa, respectively. The average tensile strength, ultimate strain, and tangent modulus for the transverse specimens was 1.7 +/- 0.5 MPa, 11.7 +/- 0.9 percent, and 11.0 +/- 3.6 MPa, respectively. All three constitutive models described the longitudinal behavior of the ligament equally well. However, the ability of the models to describe the transverse behavior of the ligament varied.     

Mechanical properties of metaphyseal bone in the proximal femur

We used a three-point bending test to investigate the structural behavior of 123 rectangular flat plate specimens harvested from the metaphyseal shell of the cervical and intertrochanteric regions of five fresh/frozen human proximal femora. For comparison purposes, 36 specimens of similar geometry were also fabricated from bone of the femoral diaphysis. All specimens were oriented in either the local longitudinal or transverse directions. The mean longitudinal elastic modulus was 9650 +/- 2410 (SD) MPa and demonstrated a 24% decrease from that measured for the diaphysis (12500 +/- 2140 MPa) using the same testing technique. However, the transverse elastic moduli did not differ significantly between the proximal (5470 +/- 1720 MPa) and diaphyseal (5990 +/- 1520 MPa) specimens. The globally averaged values for the ultimate tensile strengths of the metaphyseal shell were 101 +/- 26 MPa in the longitudinal and 50 +/- 12 MPa in the transverse directions. These compared with diaphyseal values of 128 +/- 16 MPa and 47 +/- 12 MPa, respectively. While these differences were largely due to the reduced density of the proximal specimens, a slight decrease in transverse anisotropy for the proximal specimens was also noted by comparing the ratio of longitudinal to transverse moduli (1.76) and tensile strength (2.02) to the diaphyseal values (2.09 and 2.71, respectively). Use of these data should lead to improved performance of analytical models for the proximal femur, and thus help focus increased attention on the structural contribution of trabecular bone to the strength and rigidity of the proximal femur.     

Modeling the stability of the human glenohumeral joint during external rotation

An analytical model of the human glenohumeral joint was developed to predict glenohumeral kinematics and investigate how the glenohumeral capsule and articular contact between the humeral head and the glenoid stabilize the joint. This was performed during a simulation of an apprehension clinical exam or the cocked phase of throwing, when the humerus is susceptible to anterior instability or dislocation. Contact between the joint surfaces was modeled using a deformable articular contact method and the capsule was modeled as five elements with the ability to wrap around the surface of the humeral head. Experimental measurements (Novotny et al., Journal of Shoulder and Elbow surgery, 1998, 7, 629-639) provided geometric data from four in vitro specimens and kinematic results to validate model predictions. Material properties were taken from the literature. An equilibrium approach was used with the forces and moments produced by the ligaments and surface contact balanced against those applied externally to the humerus during external rotation of the abducted and extended humerus. The six equilibrium equations were solved for the position and orientation of the humerus. The center of the humeral head translated posteriorly and superiorly with external rotation. Model predictions for translational and rotational ranges of motion were not significantly different from experimental findings; however, at individual moment increments, the model underestimated the external rotation and overestimated the superior-inferior position of the humerus relative to the glenoid. The anterior band of the inferior glenohumeral ligament increased in tension with external rotation, while the axillary pouch and posterior band decreased in tension. Contact area, stress and force increased with external rotation and the contact area moved posteriorly and inferiorly around the rim of the glenoid. The model results provide information on how the relationship between the ligament element tensions and contact forces may act to avoid glenohumeral instability.     

The impact of glenoid labrum thickness and modulus on labrum and glenohumeral capsule function

The glenoid labrum is an integral component of the glenohumeral capsule's insertion into the glenoid, and changes in labrum geometry and mechanical properties may lead to the development of glenohumeral joint pathology. The objective of this research was to determine the effect that changes in labrum thickness and modulus have on strains in the labrum and glenohumeral capsule during a simulated physical examination for anterior instability. A labrum was incorporated into a validated, subject-specific finite element model of the glenohumeral joint, and experimental kinematics were applied simulating application of an anterior load at 0 deg, 30 deg, and 60 deg of external rotation and 60 deg of glenohumeral abduction. The radial thickness of the labrum was varied to simulate thinning tissue, and the tensile modulus of the labrum was varied to simulate degenerating tissue. At 60 deg of external rotation, a thinning labrum increased the average and peak strains in the labrum, particularly in the labrum regions of the axillary pouch (increased 10.5% average strain) and anterior band (increased 7.5% average strain). These results suggest a cause-and-effect relationship between age-related decreases in labrum thickness and increases in labrum pathology. A degenerating labrum also increased the average and peak strains in the labrum, particularly in the labrum regions of the axillary pouch (increased 15.5% strain) and anterior band (increased 10.4% strain). This supports the concept that age-related labrum pathology may result from tissue degeneration. This work suggests that a shift in capsule reparative techniques may be needed in order to include the labrum, especially as activity levels in the aging population continue to increase. In the future validated, finite element models of the glenohumeral joint can be used to explore the efficacy of new repair techniques for glenoid labrum pathology.     

Methodology and sensitivity studies for finite element modeling of the inferior glenohumeral ligament complex

The objectives of this research were to develop a methodology for three-dimensional finite element (FE) modeling of the inferior glenohumeral ligament complex (IGHL complex) as a continuous structure, to determine optimal mesh density for FE simulations, to examine strains and forces in the IGHL complex in clinically relevant joint positions, and to perform sensitivity studies to assess the effects of assumed material properties. A simple translation test in the anterior direction was performed on a cadaveric shoulder, with the humerus oriented at 60 degrees of glenohumeral abduction and 0 degrees of flexion/extension, at 0 degrees , 30 degrees and 60 degrees of humeral external rotation. The geometries of the relevant structures were extracted from volumetric CT data to create a FE model. Experimentally measured kinematics were applied to the FE model to simulate the simple translation test. First principal strains, insertion site forces and contact forces were analyzed. At maximum anterior humeral translation, strains in the IGHL complex were highly inhomogeneous for all external rotation angles. The motion of the humerus with respect to the glenoid during the simple translation test produced a tangential load at the proximal and distal edges of the IGHL complex. This loading was primarily in the plane of the inferior glenohumeral ligament complex, producing an in-plane shear-loading pattern. There was a significant increase in strain with increasing angle of external rotation. The largest insertion site forces occurred at the axillary pouch insertion to the humerus (36.7N at 60 degrees of external rotation) and the highest contact forces were between the anterior band of the IGHL complex and the humeral cartilage (7.3N at 60 degrees of external rotation). Strain predictions were highly sensitive to changes in the ratio of bulk to shear modulus of the IGHL complex, while predictions were moderately sensitive to changes in elastic modulus of the IGHL complex. Changes to the material properties of the humeral cartilage had little effect on predicted strains. The methodologies developed in this research and the results of the mesh convergence and sensitivity studies provide a basis for the subject-specific modeling of the mechanics of the IGHL complex.     

Tensile damage and its effects on cortical bone

Plexiform bovine bone samples are repeatedly loaded in tension along their longitudinal axis. In order to induce damage in the bone tissue, bone samples are loaded past their yield point. Half of the bone samples from the damaged group were stored in saline to allow for viscoelastic recovery while the others were decalcified. Tensile tests were conducted on these samples to characterize the effects of damage on the mechanical behavior of the organic matrix (decalcified samples) as well as on bone tissue (stored in saline). The ultimate strain of the damaged decalcified bone is 29% higher compared to that of non-damaged decalcified (control) bone. The ultimate stresses as well as the elastic moduli are similar in both decalcified groups. This phenomenon is also observed in other collagenous tissue (tendon and ligament). This may suggest that damage in bone is caused by shear failure of the organic matrix; transverse separation of the collagen molecules or microfibrils from each other. In contrast, there is a trend towards lowered ultimate strains in damaged bone, which is soaked in saline, with respect to control bone samples (not damaged). The damaged bone tissue exhibits a bi-linear behavior in contrast to the mechanical behavior of non-damaged bone. The initial elastic modulus (below 55 MPa) and ultimate strength of damaged bone are similar to that in non-damaged bone.     

Topographic mapping of the superior transverse scapular ligament: a cadaver study to facilitate suprascapular nerve decompression

Division of the superior transverse scapular ligament for decompression of suprascapular nerve entrapment can be curative. However, the superior transverse scapular ligament can be difficult to locate, and large incisions are often required. This study was designed to determine the topographic coordinates of the superior transverse scapular ligament to permit reproducible surgical localization and reduce incision size. In 20 cadavers, the superior transverse scapular ligament was identified through a superior approach. Measurements were obtained from the superior transverse scapular ligament to external landmarks. The superior transverse scapular ligament was located 1.3 +/- 0.3 cm (+/- SD) posterior to the posterior border of the clavicle and 2.9 +/- 0.8 cm from the acromioclavicular joint in a two-dimensional surface plane. The depth of the superior transverse scapular ligament from the skin surface was 3.9 +/- 0.7 cm. An incision (mean length, 6.3 +/- 0.7 cm) derived from a novel system of planning marks facilitated access to the superior transverse scapular ligament. The authors conclude that the superior transverse scapular ligament can be located consistently through an incision located on the superior aspect of the shoulder on the basis of palpable topographic landmarks. The superior approach permits small incision size and the maintenance of local muscle anatomic integrity.     

Methodology to determine failure characteristics of planar soft tissues using a dynamic tensile test

Predicting the injury risk in automotive collisions requires accurate knowledge of human tissues, more particularly their mechanical properties under dynamic loadings. The present methodology aims to determine the failure characteristics of planar soft tissues such as skin, hollow organs and large vessel walls. This consists of a dynamic tensile test, which implies high-testing velocities close to those in automotive collisions. To proceed, I-shaped tissue samples are subjected to dynamic tensile tests using a customized tensile device based on the drop test principle. Data acquisition has especially been adapted to heterogeneous and soft biological tissues given that standard measurement systems (considered to be global) have been completed with a non-contact and full-field strain measurement (considered to be local). This local measurement technique, called the Image Correlation Method (ICM) provides an accurate strain analysis by revealing strain concentrations and avoids damaging the tissue. The methodology has first been applied to human forehead skin and can be further expanded to other planar soft tissues. The failure characteristics for the skin in terms of ultimate stress are 3 MPa +/- 1.5 MPa. The ultimate global longitudinal strains are equal to 9.5%+/-1.9% (Green-Lagrange strain), which contrasts with the ultimate local longitudinal strain values of 24.0%+/-5.3% (Green-Lagrange strain). This difference is a consequence of the tissue heterogeneity, clearly illustrated by the heterogeneous distribution of the local strain field. All data will assist in developing the tissue constitutive law that will be implemented in finite element models.     

Effect of fiber orientation and strain rate on the nonlinear uniaxial tensile material properties of tendon

Tendons are exposed to complex loading scenarios that can only be quantified by mathematical models, requiring a full knowledge of tendon mechanical properties. This study measured the anisotropic, nonlinear, elastic material properties of tendon. Previous studies have primarily used constant strain-rate tensile tests to determine elastic modulus in the fiber direction. Data for Poisson's ratio aligned with the fiber direction and all material properties transverse to the fiber direction are sparse. Additionally, it is not known whether quasi-static constant strain-rate tests represent equilibrium elastic tissue behavior. Incremental stress-relaxation and constant strain-rate tensile tests were performed on sheep flexor tendon samples aligned with the tendon fiber direction or transverse to the fiber direction to determine the anisotropic properties of toe-region modulus (E0), linear-region modulus (E), and Poisson's ratio (v). Among the modulus values calculated, only fiber-aligned linear-region modulus (E1) was found to be strain-rate dependent. The E1 calculated from the constant strain-rate tests were significantly greater than the value calculated from incremental stress-relaxation testing. Fiber-aligned toe-region modulus (E(1)0 = 10.5 +/- 4.7 MPa) and linear-region modulus (E1 = 34.0 +/- 15.5 MPa) were consistently 2 orders of magnitude greater than transverse moduli (E(2)0 = 0.055 +/- 0.044 MPa, E2 = 0.157 +/- 0.154 MPa). Poisson's ratio values were not found to be rate-dependent in either the fiber-aligned (v12 = 2.98 +/- 2.59, n = 24) or transverse (v21 = 0.488 +/- 0.653, n = 22) directions, and average Poisson's ratio values in the fiber-aligned direction were six times greater than in the transverse direction. The lack of strain-rate dependence of transverse properties demonstrates that slow constant strain-rate tests represent elastic properties in the transverse direction. However, the strain-rate dependence demonstrated by the fiber-aligned linear-region modulus suggests that incremental stress-relaxation tests are necessary to determine the equilibrium elastic properties of tendon, and may be more appropriate for determining the properties to be used in elastic mathematical models.     

An analytical approach to determine the in situ forces in the glenohumeral ligaments.

The purpose of this study was to use an analytical approach to determine the forces in the glenohumeral ligaments during joint motion. Predictions from the analytical approach were validated by comparing them to experimental data. Using a geometric model, the lengths of the four glenohumeral ligaments were determined during anterior-posterior loading simulations and forward flexion-extension. The corresponding force in each structure was subsequently calculated based on length data via load-elongation curves obtained experimentally. During the anterior loading simulation at 0 deg of abduction, the superior glenohumeral ligament carried up to 71 N at the maximally translated position. At 90 deg of abduction, the anterior band of the inferior glenohumeral ligament had the highest force of 45 N during anterior loading. These results correlated well with those found in previous experimental studies. We believe that this validated analytical approach can be used to predict the forces in the glenohumeral ligaments during more complex joint motion as well as assist surgeons during shoulder repair procedures.     

Finding consistent strain distributions in the glenohumeral capsule between two subjects: implications for development of physical examinations

The anterior-inferior glenohumeral capsule is the primary passive stabilizer to the glenohumeral joint during anterior dislocation. Physical examinations following dislocation are crucial for proper diagnosis of capsule pathology; however, they are not standardized for joint position which may lead to misdiagnoses and poor outcomes. To suggest joint positions for physical examinations where the stability provided by the capsule may be consistent among patients, the objective of this study was to evaluate the distribution of maximum principal strain on the anterior-inferior capsule using two validated subject-specific finite element models of the glenohumeral joint at clinically relevant joint positions. The joint positions with 25 N anterior load applied at 60° of glenohumeral abduction and 10°, 20°, 30° and 40° of external rotation resulted in distributions of strain that were similar between shoulders (r2 ≥ 0.7). Furthermore, those positions with 20-40° of external rotation resulted in capsule strains on the glenoid side of the anterior band of the inferior glenohumeral ligament that were significantly greater than in all other capsule regions. These findings suggest that anterior stability provided by the anterior-inferior capsule may be consistent among subjects at joint positions with 60° of glenohumeral abduction and a mid-range (20-40°) of external rotation, and that the glenoid side has the greatest contribution to stability at these joint positions. Therefore, it may be possible to establish standard joint positions for physical examinations that clinicians can use to effectively diagnose pathology in the anterior-inferior capsule following dislocation and lead to improved outcomes.     

Determination of layer-specific mechanical properties of human coronary arteries with nonatherosclerotic intimal thickening and related constitutive modeling

At autopsy, 13 nonstenotic human left anterior descending coronary arteries [71.5 +/- 7.3 (mean +/- SD) yr old] were harvested, and related anamnesis was documented. Preconditioned prepared strips (n = 78) of segments from the midregion of the left anterior descending coronary artery from the individual layers in axial and circumferential directions were subjected to cyclic quasi-static uniaxial tension tests, and ultimate tensile stresses and stretches were documented. The ratio of outer diameter to total wall thickness was 0.189 +/- 0.014; ratios of adventitia, media, and intima thickness to total wall thickness were 0.4 +/- 0.03, 0.36 +/- 0.03, and 0.27 +/- 0.02, respectively; axial in situ stretch of 1.044 +/- 0.06 decreased with age. Stress-stretch responses for the individual tissues showed pronounced mechanical heterogeneity. The intima is the stiffest layer over the whole deformation domain, whereas the media in the longitudinal direction is the softest. All specimens exhibited small hysteresis and anisotropic and strong nonlinear behavior in both loading directions. The media and intima showed similar ultimate tensile stresses, which are on average three times smaller than ultimate tensile stresses in the adventitia (1,430 +/- 604 kPa circumferential and 1,300 +/- 692 kPa longitudinal). The ultimate tensile stretches are similar for all tissue layers. A recently proposed constitutive model was extended and used to represent the deformation behavior for each tissue type over the entire loading range. The study showed the need to model nonstenotic human coronary arteries with nonatherosclerotic intimal thickening as a composite structure composed of three solid mechanically relevant layers with different mechanical properties. The intima showed significant thickness, load-bearing capacity, and mechanical strength compared with the media and adventitia.     

Finite element modelling of the glenohumeral capsule can help assess the tested region during a clinical exam

The objective of this research was to examine the efficacy of evaluating the region of the glenohumeral capsule being tested by clinical exams for shoulder instability using finite element (FE) models of the glenohumeral joint. Specifically, the regions of high capsule strain produced by glenohumeral joint positions commonly used during a clinical exam were identified. Kinematics that simulated a simple translation test with an anterior load at three external rotation angles were applied to a validated, subject-specific FE model of the glenohumeral joint at 60° of abduction. Maximum principal strains on the glenoid side of the inferior glenohumeral ligament (IGHL) were significantly higher than the maximum principal strains on the humeral side, for all three regions of the IGHL at 30° and 60° of external rotation. These regions of localised strain indicate that these joint positions might be used to test the glenoid side of the IGHL during this clinical exam, but are not useful for assessing the humeral side of the IGHL. The use of FE models will facilitate the search for additional joint positions that isolate high strains to other IGHL regions, including the humeral side of the IGHL.     

Soft tissue structures resisting anterior instability in a computational glenohumeral joint model

The glenohumeral joint is the most dislocated joint in the body due to the lack of bony constraints and the dependence on soft tissue for stability. The roles that various structures provide to joint function are important for understanding injury treatment and orthopaedic device design purposes. The goal of this study was to develop a computational model of the glenohumeral joint whereby joint behaviour was dictated by articular contact, ligamentous constraints, muscle loading and external perturbations. The bone structure of the computational model consisted of assembled computer tomographic images of the scapula, humerus and clavicle. The soft tissue elements were composed of forces and tension-only springs that represented muscles and ligaments. Validation of this model was achieved by comparing computational predictions to the results of a cadaveric experiment in which the relative contribution of muscles and ligaments to anterior joint stability was examined. The computational model predicted an anterior subluxation force that was similar to the cadaveric experimental results in humeral external rotation. The individual structure results showed the subscapularis to be critical to stabilisation in both neutral and external rotations, the biceps stabilised the joint in neutral but not in external rotation, and the inferior glenohumeral ligament resisted anterior displacement only in external rotation. The model's predictions were similar to the conclusions of the cadaveric experiment and the literature. Knowledge gained from this type of model could assist in further understanding the contribution of soft tissue stabilisers to joint function, pre-operative planning or the design of orthopaedic implants.     

Glenohumeral elevation-dependent influence of anterior glenohumeral capsular lesions on passive axial humeral rotation

The purpose of this study was to assess the effect of standardized anterior glenohumeral capsular lesions on axial humeral rotation in a full arc of glenohumeral elevation. Using a testing apparatus, the range of internal and external humeral rotation was assessed in an arc of glenohumeral elevation in the scapular plane with steps of 15 degrees in six isolated shoulder joint specimens. Cutting of the glenohumeral joint capsule 1 cm laterally from, and parallel to the glenoid rim was performed in seven steps of 1 cm till the anterior capsule was cut. Capsular lesions were made in three ways: from inferior, from superior and from the middle of the capsule. Anterior capsular lesions resulted in significant increase of external humeral rotation. This occurred particularly at 15-60 degrees glenohumeral elevation. Lesions of the inferior part of the capsule mainly increased external rotation at 30-60 degrees glenohumeral elevation, lesions of the superior part mainly in lower elevation angles and lesions of the middle more gradually in the range till 60 degrees of glenohumeral elevation. Cutting of the anterior glenohumeral capsule barely increased passive axial humeral rotation at elevation angles over 60 degrees. Above 60 degrees glenohumeral elevation, tightening of the inferior posterior glenohumeral joint capsule prevented both internal and, increasingly, external humeral rotation. From these observations it is concluded that increased external rotation correlates with progressive anterior capsular lesions, mainly below 60 degrees glenohumeral elevation. To assess anterior glenohumeral capsular lesions in patients, axial humeral rotation tests should probably not exceed 60 degrees glenohumeral elevation, i.e. 90 degrees thoracohumeral elevation.     

Mechanical properties of the avian acrocoracohumeral ligament and its role in shoulder stabilization in flight

Control of movement in the avian shoulder joint is fundamental to understanding the avian wingstroke. The acrocoracohumeral ligament (AHL) is thought to play a key role in stabilizing the glenoid and balancing the pectoralis in gliding flight. If the AHL has to be taut to balance the pectoralis, then it must constrain glenohumeral motion during flapping flight as well. However, birds vary wing kinematics depending on flight speed and behavior. How can a passive ligament accommodate such varying joint movements? Herein, mechanical testing and 3-D modeling are used to link the mechanical properties and morphology of the AHL to its functional role during flapping flight. The bone-ligament-bone complex of the pigeon (Columba livia) fails at a tensile loading of 141 ± 18 N (± s .D., n = 10) or 39 times body weight, which corresponds to a failure stress of 51 MPa, well above expected loads during flight. Simulated AHL length changes, comparisons to glenohumeral kinematics from the literature, and manipulations of partially dissected pigeon specimens all support the hypothesis that the AHL remains taut through downstroke and most of upstroke while becoming slack during the downstroke/upstroke transition. The digital AHL model provides a mechanism for explaining how the AHL can stabilize the shoulder joint under a broad array of humeral paths by constraining the coordination of glenohumeral degrees of freedom.     

Permeability of human medial collateral ligament in compression transverse to the collagen fiber direction

This study quantified the apparent and intrinsic hydraulic permeability of human medial collateral ligament (MCL) under direct permeation transverse to the collagen fiber direction. A custom permeation device was built to apply flow across cylindrical samples of ligament while monitoring the resulting pressure gradient. MCLs from 5 unpaired human knees were used (donor age 55 +/- 16 yr, 4 males, 1 female). Permeability measurements were performed at 3 levels of compressive pre-strain (10%, 20% and 30%) and 5 pressures (0.17, 0.34, 1.03, 1.72 and 2.76 MPa). Apparent permeability was determined from Darcy's law, while intrinsic permeability was determined from the zero-pressure crossing of the pressure-permeability curves at each compressive pre-strain. Resulting data were fit to a finite deformation constitutive law [Journal of Biomechanics 23 (1990) 1145-1156]. The apparent permeability of human MCL ranged from 0.40 +/- 0.05 to 8.60 +/- 0.77 x 10(-16) m(4)/Ns depending on pre-strain and pressure gradient. There was a significant decrease in apparent permeability with increasing compressive pre-strain (p=0.024) and pressure gradient (p<0.001), and there was a significant interaction between the effects of compressive pre-strain and pressure (p<0.001). Intrinsic permeability was 14.14 +/- 0.74, 6.30 +/- 2.13 and 4.29 +/- 1.71 x 10(-16) m(4)/Ns for compressive pre-strains of 10%, 20% and 30%, respectively. The intrinsic permeability showed a faster decrease with increasing compressive pre-strain than that of bovine articular cartilage. These data provide a baseline for investigating the effects of disease and chemical modification on the permeability of ligament and the data should also be useful for modeling the poroelastic material behavior of ligaments.     

Glenohumeral joint cartilage contact in the healthy adult during scapular plane elevation depression with external humeral rotation

The shoulder (glenohumeral) joint has the greatest range of motion of all human joints; as a result, it is particularly vulnerable to dislocation and injury. The ability to non-invasively quantify in-vivo articular cartilage contact patterns of joints has been and remains a difficult biomechanics problem. As a result, little is known about normal in-vivo glenohumeral joint contact patterns or the consequences that surgery has on altering them. In addition, the effect of quantifying glenohumeral joint contact patterns by means of proximity mapping, both with and without cartilage data, is unknown. Therefore, the objectives of this study are to (1) describe a technique for quantifying in-vivo glenohumeral joint contact patterns during dynamic shoulder motion, (2) quantify normal glenohumeral joint contact patterns in the young healthy adult during scapular plane elevation depression with external humeral rotation, and (3) compare glenohumeral joint contact patterns determined both with and without articular cartilage data. Our results show that the inclusion of articular cartilage data when quantifying in-vivo glenohumeral joint contact patterns has significant effects on the anterior–posterior contact centroid location, the superior–inferior contact centroid range of travel, and the total contact path length. As a result, our technique offers an advantage over glenohumeral joint contact pattern measurement techniques that neglect articular cartilage data. Likewise, this technique may be more sensitive than traditional 6-Degree-of-Freedom (6-DOF) joint kinematics for the assessment of overall glenohumeral joint health. Lastly, for the shoulder motion tested, we found that glenohumeral joint contact was located on the anterior–inferior glenoid surface.     

Regional structural and viscoelastic properties of fibrocartilage upon dynamic nanoindentation of the articular condyle

Fibrocartilage,a tissue with macromaterial properties between dense fibrous tissue and hyaline cartilage, is not well understood in its ultrastructure and regional viscoelastic properties. Here nanoindentation with atomic force microscopy was performed on fresh fibrocartilage samples of rabbit jaw joint condyles. Each sample was divided into anteromedial, anterolateral, posteromedial, and posterolateral regions for probing and topographic imaging in 2 x 2 microm and 10 x 10 microm scan sizes. Young's moduli differed significantly among these regions in a descending gradient from the anteromedial (2.34 +/- 0.26 MPa) to the posterolateral (0.95 +/- 0.06 MPa). The Poisson ratio, defined as lateral strain over axial strain, had the same gradient distribution: highest for the anteromedial region (0.46 +/- 0.05) and lowest for the posterolateral region (0.31 +/- 0.05). The same four regions showed a descending gradient of surface roughness: highest for the anteromedial (321.6 +/- 13.8 nm) and lowest for the posterolateral (155.6 +/- 12.6 nm). Thus, the regional ultrastructural and viscoelastic properties of fibrocartilage appear to be coregulated. Based on these region-specific gradient distributions, fibrocartilage is constructed to withstand tissue-borne shear stresses, which likely propagate across its different regions. A model of shear gradient and concentric gradient is proposed to describe the region-specific capacity of fibrocartilage to sustain shear stresses in tendons, ligaments, joints, and the healing bone across species.