Study to localize isometric points of anterior band of inferior glenohumeral ligament and to use long head of biceps as a graft: A finite element analysis and arthroscopic cadaveric demonstration
Bibliographic record
Abstract
BACKGROUND: The inferior glenohumeral ligament (IGHL) comprising the anterior and posterior bands with interposing axillary pouch is an important static stabilizer of anterior translation and external rotation (ER) in the 90-degree abduction position. No literature is available to determine any ideal graft or isometric point for fixation of any graft to replace the functionality of IGHL such that the tensile stress acting on the graft is under the limits of the tensile properties of the graft used for reconstruction. METHODS: Using finite element method analysis (FEM) of the long head of the biceps tendon (LHBT) with modeling and simulation process, the ultimate tensile strength of the LHBT at the different clock positions of the humeral head attachment and angular positions of the humerus were determined through a combination of Taguchi Design of Experiments and simulation using ANSYS (Analysis system) software. RESULTS: Through FEM simulations using the ANSYS software, it was concluded that the clock position of 7:30 would be appropriate to fix the biceps Tendon on the humerus. The tensile stress induced in the IGHL at 7:30 on the humerus, at 90° abduction with 90° rotation of the humerus, as well as at 120° abduction with 90° rotation of the humerus was evaluated and validated. CONCLUSIONS: Reconstruction of anterior band of IGHL using LHBT in its isometric points found in this study can provide a solution to manage anterior instability anatomically rather than non-anatomical procedures like dynamic anterior stabilization. This will be an anatomical procedure that will bridge the gap between anatomical Bankarts procedure and non-anatomical latarjet procedure. The LHBT can be suitable graft material for the anterior band of the IGHL reconstruction. Our study demonstrated that the most optimal fixation points for the graft, which resulted in the least tensile stress on the LHBT, were found to be at the 3 o'clock position on the glenoid and the 7:30 o'clock position on the humerus. LEVEL OF EVIDENCE: LEVEL 5 - methodological verification and validation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".