O'Brien and colleagues examined the inferior glenohumeral ligament arthroscopically and histologically to define its components and its glenoid and humeral attachments.
Cadaver study of 11 fresh frozen shoulders (7 right, 4 left, donor age and sex unknown) at the Hospital for Special Surgery.
Methods
Specimens
11 fresh frozen cadaver shoulders
Method
Arthroscopic viewing of the capsule through the normal range of motion
Histologic examination of the joint capsule
Measurements
Components of the ligament complex
Glenoid origin of each band
Humeral attachment pattern
Collagen organization and layering
Key Findings
All 11 shoulders had a three‑part inferior glenohumeral ligament complex: anterior and posterior bands with an axillary pouch of thickened capsule lying between them.
In 90° of abduction the bands appeared to tighten reciprocally like a hammock, the posterior band fanning out behind the head in internal rotation and the anterior band in front of it in external rotation.
Histologically, the anterior and posterior bands were abrupt thickenings of the inner capsular layer, made of coarse, well‑organized collagen bundles running coronally from glenoid to humerus.
The capsule over the complex had three collagen layers: the inner and outer layers ran coronally and the middle layer ran at 90° to both.
The middle glenohumeral ligament was entirely absent in 3 shoulders (27%), and the superior glenohumeral ligament was almost nonexistent in one other.
The axillary pouch was the thickest part of the capsule, but its collagen was less organized than in the bands and its outer layer was virtually absent.
Board pearl
On the glenoid clock face, the anterior band of the IGHL complex arises between 2 and 4 o'clock and the posterior band between 7 and 9 o'clock.
Authors' conclusion
The orientation and design of the inferior glenohumeral ligament complex supports the functional concept of this single structure as an important anterior and posterior stabilizer of the shoulder joint.
O'Brien and colleagues examined the inferior glenohumeral ligament arthroscopically and histologically to define its components and its glenoid and humeral attachments.
Cadaver study of 11 fresh frozen shoulders (7 right, 4 left, donor age and sex unknown) at the Hospital for Special Surgery.
Methods
Specimens
11 fresh frozen cadaver shoulders
Method
Arthroscopic viewing of the capsule through the normal range of motion
Histologic examination of the joint capsule
Measurements
Components of the ligament complex
Glenoid origin of each band
Humeral attachment pattern
Collagen organization and layering
Key Findings
All 11 shoulders had a three‑part inferior glenohumeral ligament complex: anterior and posterior bands with an axillary pouch of thickened capsule lying between them.
In 90° of abduction the bands appeared to tighten reciprocally like a hammock, the posterior band fanning out behind the head in internal rotation and the anterior band in front of it in external rotation.
Histologically, the anterior and posterior bands were abrupt thickenings of the inner capsular layer, made of coarse, well‑organized collagen bundles running coronally from glenoid to humerus.
The capsule over the complex had three collagen layers: the inner and outer layers ran coronally and the middle layer ran at 90° to both.
The middle glenohumeral ligament was entirely absent in 3 shoulders (27%), and the superior glenohumeral ligament was almost nonexistent in one other.
The axillary pouch was the thickest part of the capsule, but its collagen was less organized than in the bands and its outer layer was virtually absent.
Board pearl
On the glenoid clock face, the anterior band of the IGHL complex arises between 2 and 4 o'clock and the posterior band between 7 and 9 o'clock.
Authors' conclusion
The orientation and design of the inferior glenohumeral ligament complex supports the functional concept of this single structure as an important anterior and posterior stabilizer of the shoulder joint.