The Collagen Fiber Kinematics in the Anteroinferior Glenohumeral Capsule Are Not Affine-Predicted

Glenohumeral dislocation is a significant clinical problem and often results in injury to the anteroinferior (anterior band of the inferior glenohumeral ligament (AB-IGHL) and axillary pouch) glenohumeral capsule. [1] However, clinical exams to diagnose capsular injuries are not reliable [2] and poor patient outcome still exists following repair procedures. [3] Validated finite element models of the glenohumeral capsule may be able to improve diagnostic and repair techniques; however, improving the accuracy of these models requires adequate constitutive models to describe capsule behavior. The collagen fibers in the anteroinferior capsule are randomly oriented [4], thus the material behavior of the glenohumeral capsule has been described using isotropic models. [5,6] A structural model consisting of an isotropic matrix embedded with randomly aligned collagen fibers proved to better predict the complex capsule behavior than an isotropic phenomenological model [7] indicating that structural models may improve the accuracy of finite element models of the glenohumeral joint. Many structural models make the affine assumption (local fiber kinematics follow global tissue deformation) however an approach to account for non-affine fiber kinematics in structural models has been recently developed [8]. Evaluating the affine assumption for the capsule would aid in developing an adequate constitutive model. Therefore, the objective of this work was to assess the affine assumption of fiber kinematics in the anteroinferior glenohumeral capsule by comparing experimentally measured preferred fiber directions to the affine-predicted fiber directions.