a b s t r a c tBackground: Rotator cuff muscle degeneration is an important parameter to consider when planning shoulder arthroplasty. Hypothesis: We hypothesized that rotator cuff muscle degeneration is correlated with scapulohumeral subluxation in patients planned for anatomical total shoulder arthroplasty (TSA). Materials and methods: We developed a semi-automated quantitative CT method to measure rotator cuff muscle degeneration, and retrospectively analyzed 107 preoperative shoulder CT scans of patients with primary osteoarthritis. On a standardized sagittal-oblique CT slice perpendicular to the scapular axis, two observers measured the cross-sectional areas of residual rotator cuff muscle tissues, normalized by the estimated area of healthy muscles. Muscle degeneration was quantified in a semi-automated manner, and divided into atrophy and fatty infiltration. Scapulohumeral subluxation was determined in 3D as the distance between the humeral head center and the glenoid surface center, projected on the same CT slice, and normalized by the humeral head radius. We tested all potential correlations between muscle degeneration and scapulohumeral subluxation. Results: Muscle degeneration, primarily due to atrophy, predominated in the supraspinatus; it varied from 0.8% to 88.8%. Scapulohumeral subluxation varied from 2.5% to 72.9%, and was mainly in a posterior and postero-superior orientation. There was a significant but weak correlation between the amount of subluxation and both supraspinatus (R = 0.207, P = 0.032) and infraspinatus (R = 0.225, P = 0.020) degeneration. Inter-and intra-observer reproducibility of muscle degeneration measurements were both excellent respectively). Conclusion: This new semi-automated CT method allows to quantitatively and reproducibly measure rotator cuff muscle degeneration in shoulders with primary osteoarthritis. Muscle degeneration is weakly correlated with scapulohumeral subluxation in patients planned for anatomical TSA. Level of evidence: Level IV. Type of study: Diagnostic retrospective study.

Body weight supported treadmill training is an approach to gait rehabilitation following a stroke or spinal cord injury. Although lateral control of balance is an important aspect of walking, many of the currently available body weight support systems have a fixed pulley configuration which can lead to lateral forces being developed in the supporting cables, interfering with the lateral balance task. In this paper, a novel extension for body weight support systems, used for treadmill walking, is presented which features a system of pulleys and trolleys. A model is developed for the device along with a basic feedback controller in order to enable simulation of the concept. The lateral forces induced by the novel system are greatly reduced in comparison to a fixed pulley system. This device has applications in balance training within gait rehabilitation programs.

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