{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T10:55:41Z","timestamp":1773572141276,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T00:00:00Z","timestamp":1435622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T00:00:00Z","timestamp":1435622400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T00:00:00Z","timestamp":1435622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","arthroscopyjournal.org","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantify the effect of different size combinations of Hill\u2010Sachs defects and bony Bankart defects on shoulder instability across a broad range of motion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A computer\u2010based finite element approach was used to model an\u00a0intact glenohumeral joint. Defects were created for the glenoid with respect to its width (12.5%, 25%, 37.5%, and 50%). The defect sizes chosen for the humeral head were 6%, 19%, 31%, and 44% of the diameter. Simulations were analyzed using quasi\u2010static analysis with displacement control under 50 N of medial compression. Distance to dislocation (DTD) was the primary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Every progressive bony Bankart defect lowered the value of DTD (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001). These DTD values of individual glenoid defects were the same for every abduction and rotation angle. This may be an artifact due to the glenoid's spherical\u2010shape assumption, which was necessary for the sample\u2010specific model and is not a completely accurate representation of specimen\u2010specific geometry. The largest glenoid defect size had a DTD value of 0 mm, which signifies no contact between surfaces. At 90\u00b0 of abduction, Hill\u2010Sachs defect sizes 19%, 31% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), and 44% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) further reduced DTD values gradually after 30\u00b0 of external rotation, 10\u00b0 of external rotation, and 20\u00b0 of internal rotation, respectively. This signifies loss of contact between articulating surfaces, resulting in reduced motion. However, at a 45\u00b0 abduction angle, the loss of contact only occurred for humeral head defect sizes 31% and 44%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This model shows that increasing shoulder instability is predicted by increasing humeral head and glenoid defect sizes for a broad envelope of motion. The size of glenoid defect can be used to determine the baseline stability. An additional humeral head defect can further reduce the stability when the arm is in external rotation because of loss of contact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>The data from this study will be helpful in establishing thresholds for performing bony reconstructions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2015.04.099","type":"journal-article","created":{"date-parts":[[2015,7,4]],"date-time":"2015-07-04T14:51:39Z","timestamp":1436021499000},"page":"2119-2127","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Influence of Combined Hill\u2010Sachs and Bony Bankart Defects on Range of Motion in Anterior Instability of the Shoulder in a Finite Element Model"],"prefix":"10.1002","volume":"31","author":[{"given":"Piyush","family":"Walia","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Lerner Research Institute Cleveland Clinic Cleveland Ohio U.S.A."},{"name":"Department of Orthopaedic Surgery Summa Health System Akron Ohio U.S.A."},{"name":"Department of Chemical and Biomedical Engineering Cleveland State University Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Miniaci","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Lerner Research Institute Cleveland Clinic Cleveland Ohio U.S.A."},{"name":"Department of Orthopaedic Surgery Cleveland Clinic Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan H.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Lerner Research Institute Cleveland Clinic Cleveland Ohio U.S.A."},{"name":"Department of Orthopaedic Surgery Cleveland Clinic Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D.","family":"Fening","sequence":"additional","affiliation":[{"name":"Case Western Reserve University Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,30]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(89)90138-2"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466020-00001"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.17715"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00906"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330139"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200001000-00005"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509350295"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509341576"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B9.18467"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.07.008"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2006.03760.x"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22267"},{"issue":"285","key":"e_1_2_2_14_2","first-page":"181","article-title":"Articular 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