{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:23:20Z","timestamp":1761017000564},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T00:00:00Z","timestamp":1358380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Provost's Development Fund"},{"name":"Swanson School of Engineering at the University of Pittsburgh"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>During shoulder dislocation, the glenohumeral capsule undergoes non\u2010recoverable strain, leading to joint instability. Clinicians use physical exams to diagnose injury and direct repair procedures; however, they are subjective and do not provide quantitative information. Our objectives were to: (1) determine the relationship between capsule function following anterior dislocation and non\u2010recoverable strain; and (2) identify joint positions at which physical exams can be used to detect non\u2010recoverable strain in specific capsule regions. Physical exams were simulated at three joint positions including external rotation (ER) using robotic technology before and after anterior dislocation. The resulting joint kinematics, strain distribution in the capsule, and non\u2010recoverable strain were determined. Following dislocation, anterior translation increased by as much as 48% (0\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009=\u20090.03; 30\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009=\u20090.03; 60\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Capsule sub\u2010regions with less non\u2010recoverable strain required more ER to detect differences in the strain ratios between the intact and injured joint. Strain ratio changes on the humeral side of the posterior axillary pouch (0.31\u2009\u00b1\u20090.32) were significant at all joint positions (0\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009=\u20090.03; 30\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009=\u20090.048; 60\u00b0 ER: <jats:italic>p<\/jats:italic>\u2009=\u20090.04), whereas strain ratio differences on the humeral side of the anterior axillary pouch (0.18\u2009\u00b1\u20090.21) were significant only at 60\u00b0 of ER (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Therefore, standardizing physical exams for joint position could help surgeons identify specific locations of non\u2010recoverable strain that may have been ignored. \u00a9 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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