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Patient-Specific Strategies for Capsular Repair Following Shoulder Dislocations

Award Number: R21AR078418
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Patient-Specific Strategies for Capsular Repair Following Shoulder Dislocations - Project Summary Traumatic dislocation of the shoulder is an injury that commonly affects young athletes and has been associated with recurrent instability despite surgical repair. This recurrent instability leads to long-term disability due to early osteoarthritis and loss of shoulder function. Recently, we have characterized the location, magnitude, and direction of capsular injury following multiple shoulder dislocations. The findings of these studies show that the capsular injury pattern following dislocation occurs at regions not previously addressed during surgery and depends on the number of dislocations. This suggests that a more injury-specific capsular repair might be needed in order to improve shoulder function post-operatively. The overall objective of the proposed project is to assess the restoration of glenohumeral kinematics following multiple dislocations using injury-specific capsular repair strategies. Our overall hypothesis is that capsular plication procedures must account for magnitude and direction of injury to properly restore normal joint stability. The first step to achieve this goal is to develop an optimized design for injury-specific capsular repair based on non-recoverable strain data (capsular injury) that best restores kinematics to those of the intact shoulder. (Aim 1a) A novel robotic testing system will dislocate cadaveric shoulders and simulate clinical exams to assess joint stability. An optical tracking system will quantify the non-recoverable strain. In order to translate this information to the clinical setting, the non-recoverable strain data will be correlated with capsular surface area changes as quantified on MR arthrogram. (Aim 1b) Finally, MR arthrograms will be used to characterize capsular injury before and after surgical repair in subjects that have dislocated their shoulders. The contralateral shoulder will serve as a control and allow assessment of areas of the capsule that current repair methods do not adequately address (Aim 2). The findings of this study will further validate the need for injury-specific repair strategies and provide a solution that can ultimately be implemented in a future randomized controlled trial. Exploring injury-specific strategies can help improve shoulder function and reduce the rate of recurrent instability following capsular repair. Thus, guidelines could be developed to direct the treatment of athletes that experience multiple dislocations throughout a season. Finally, the cost and disability associated with the long-term sequelae of multiple shoulder dislocations will be reduced.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = -$12,822 )
2024	2022	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	5/22/2024	NON-COMPETING CONTINUATION	-$12,822
														Subtotal = -$12,822

Issue Date FY: 2022 ( Subtotal = $198,494 )
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	12/16/2021	NON-COMPETING CONTINUATION	$180,448
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	2	5/9/2022	NON-COMPETING CONTINUATION	$18,046
														Subtotal = $198,494

Issue Date FY: 2021 ( Subtotal = $164,640 )
2021	2021	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	12/30/2020	NEW	$164,640
														Subtotal = $164,640

Grand Total All Awards = $350,312

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Patient-Specific Strategies for Capsular Repair Following Shoulder Dislocations

Award Number: R21AR078418

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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