Capsular attachment of the subregions of rotator cuff muscles

Yuri, Takuma; Kobayashi, Hiroto; Takano, Yasunari; Yoshida, Saori; Naito, Akira; Fujii, Hiromi; Kiyoshige, Yoshiro

doi:10.1007/s00276-019-02288-7

Cited by 18 publications

(28 citation statements)

References 18 publications

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“…Yellow arrows indicated the border of each partition. The SWE images were displayed in color-coded map with harder tissue represented in red and softer tissue in blue the anterior margin of the highest impression of the greater tuberosity [22][23][24][25]31]. Kato et al demonstrated that the ISP muscle was comprised of two parts, namely the transverse and oblique parts [15].…”

Section: Discussionmentioning

confidence: 99%

“…3 The shear modulus at rest, at contraction and activity value for each partition during scaption at various shoulder positions. The representative SWE images were chosen at 30°, peak position (135° for superior and inferior partitions, 105° for middle partition), and 150° from measurements for shear modulus at contraction and bony insertions to the greater tuberosity [31]. Clark et al suggested that the firm capsular attachment area could contribute to a distribution of the tension to the humeral head [5].…”

Section: Discussionmentioning

confidence: 99%

“…For the inferior partition, at first, the fascia between the inferior partition of the ISP and teres minor muscles was visualized. Then, the probe was placed on the region of teres minor muscles [ 3 , 6 , 20 , 31 ]. SWE images were simultaneously displayed on the B-mode image as a square color image.…”

Section: Methodsmentioning

confidence: 99%

“…Recent detailed anatomical studies demonstrated that the ISP muscle was anatomically divided into two or three distinct neuromuscular partitions based on differences in their attachment sites, muscle fiber directions, and intramuscular innervations [3,6,15,22,31]. Several authors demonstrated that the anterior-most region of the humeral insertion of the ISP muscle almost reached the anterior margin of the highest impression of the greater tuberosity [22][23][24][25]31]. In addition, Kato et al found that one of the partitions of the ISP muscle was innervated by branches arising from the supraspinatus muscle [15].…”

Section: Introductionmentioning

confidence: 99%

“…They suggested that the superior partition contributes to abduction motion, the middle partition act as a prime external rotator, and the inferior partition has both functions. We hypothesized that the three partitions (superior, middle, and inferior partitions) of the ISP muscle previously described in anatomical studies [ 3 , 6 , 31 ] will present different behavior during scaption as described using SWE, especially during initial range of motion. A better understanding of the behavior of the individual infraspinatus muscle partitions during scaption using ultrasound elastography could provide beneficial information on patients who can hardly elevate their arms.…”

Section: Introductionmentioning

confidence: 99%

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Shoulder scaption is dependent on the behavior of the different partitions of the infraspinatus muscle

et al. 2021

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Purpose The purpose of this study was to investigate if the three partitions (superior, middle, and inferior partitions) of the infraspinatus muscle previously described in anatomical studies will present different behavior during scapular plane abduction (scaption) as described using shear-wave elastography, especially during initial range of motion. Methods Eight volunteers held their arm against gravity 15° intervals from 30° to 150° in scaption. Shear-wave elastography was implemented at each position to measure shear modulus at rest and during muscle contraction, as a surrogate for muscle stiffness, of each partition. Muscle activity was defined as the difference in stiffness values between the resting positions and those during muscle contraction (ΔE = stiffness at contraction—stiffness at rest). Results The activity value for the middle partition was 25.1 ± 10.8 kPa at 30° and increased up to 105° (52.2 ± 10.8 kPa), with a subsequent decrease at larger angle positions (p < .001). The superior partition showed a flatter and constant behavior with smaller activity values except at higher angles (p < .001). Peak activity values for the superior partition were observed at 135° (23.0 ± 12.0 kPa). Increase activity for inferior partition began at 60° and showed a peak at 135° (p < .001; 32.9 ± 13.8 kPa). Conclusion Stiffness measured using shear-wave elastography in each partition of the infraspinatus muscle demonstrated different behavior between these partitions during scaption. The middle partition generated force throughout scaption, while the superior and inferior partitions exerted force at end range.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Shoulder scaption is dependent on the behavior of the different partitions of the infraspinatus muscle

et al. 2021

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Strain distribution in the bursal rotator cuff based on whole‐muscle and muscle subregion‐specific loading: A cadaveric study

Yuri

Prado

Trevino

et al. 2023

Journal Orthopaedic Research

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Rotator cuff (RC) tears are common injuries leading to significant dysfunction of the shoulder. Rotator cuff tears alter tension and strain in muscles and tendons. Anatomical studies demonstrated that rotator cuff muscles are comprised of anatomical subregions. However, the strain distribution within the rotator cuff tendons generated from the tension from each anatomical subregion is unknown. We hypothesized that subregions would present distinct 3‐dimensional (3D) strain distributions within the rotator cuff tendons, and that the anatomical insertion configuration of the supraspinatus (SSP) and infraspinatus (ISP) tendons might dictate strain, thus tension, transmission. 3D‐strains in the bursal side of the SSP and ISP tendons of eight fresh‐frozen cadaveric intact shoulders were obtained by applying tension on the whole SSP and ISP muscles, and on their subregions using an MTS system. Strains in the anterior region of the SSP tendon were higher than in the posterior region with whole‐SSP anterior‐region (p < 0.05) and whole‐SSP muscle loading. Higher strains were observed in the inferior half of the ISP tendon with whole‐ISP muscle (p < 0.05), middle‐subregion (p < 0.01), and superior‐subregion (p < 0.05) loading. Tension generating from the posterior‐region of the SSP was primarily transmitted to the middle facet via an overlap between the SSP and ISP tendons insertions, while the anterior‐region mainly distributed its tension into the superior facet. Tension generating from the middle and superior‐regions of the ISP was distributed into the inferior portion of the ISP tendon. These results emphasize the importance of the distinct anatomical subregions of the SSP and ISP muscles in distributing the tension to the tendons.

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Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Umehara

Yagi

Ueda

et al. 2023

Journal Orthopaedic Research

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Rotator cuff tear is a common shoulder injury that causes shoulder dysfunction and pain. Although surgical repair is the primary treatment for rotator cuff tear, it is well recognized that impaired force exertion of muscles connecting to the involved tendon and subsequent complemental change in the force exertion of synergist muscles persist even after repair. This study aimed to identify the compensation strategy of shoulder abductors by examining how synergist muscles respond to supraspinatus (SSP) muscle force deficit in patients with rotator cuff repair. Muscle shear modulus, an index of muscle force, was assessed for SSP, infraspinatus, upper trapezius, and middle deltoid muscles in repaired and contralateral control shoulders of 15 patients with unilateral tendon repair of the SSP muscle using ultrasound shear wave elastography while the patients passively or actively held their arm in shoulder abduction. In the repaired shoulder, the shear modulus of the SSP muscle declined, whereas that of other synergist muscles did not differ relative to that of the control. To find the association between the affected SSP and each of the synergist muscles, a regression analysis was used to assess the shear moduli at the population level. However, no association was observed between them. At the individual level, there was a tendency of variation among patients with regard to a specific muscle whose shear modulus complementarily increased. These results suggest that the compensation strategy for SSP muscle force deficit varies among individuals, being nonstereotypical in patients with rotator cuff injury.

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Capsular attachment of the subregions of rotator cuff muscles

Cited by 18 publications

References 18 publications

Shoulder scaption is dependent on the behavior of the different partitions of the infraspinatus muscle

Shoulder scaption is dependent on the behavior of the different partitions of the infraspinatus muscle

Strain distribution in the bursal rotator cuff based on whole‐muscle and muscle subregion‐specific loading: A cadaveric study

Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

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