Correlation between rotator cuff tear and glenohumeral degeneration

Abstract

We studied the occurrence and correlation between a rotator cuff tear and glenohumeral degeneration. 44 cadaveric shoulders (22 right) were obtained from 32 subjects (18 females), mean age 73 (62-86) years and without a history of systemic diseases. Rotator cuffs were exposed and tear size (14 shoulders) was measured after removal of soft tissue and deltoid. Articular cartilage damage of the glenoid and humeral head was recorded by photography. A grading system of 1 (intact), 2 (mild) and 3 (severe) was used to determine the severity of cartilage damage. The area of articular cartilage damage was calculated using the Sonic Digitizer Analyzing System. The area of articular cartilage damage to the glenoid and the humeral head in the rotator cuff tear group was 32% and 36%, respectively. It was greater than that in the groups without a tear, which was 6% in the glenoid and 7% in the humeral head. However, it was not correlated with the size of the tear. Most of the articular cartilage damage in massive and large rotator cuff tears was located in the anterior-inferior portion of the glenoid and in the posterior portion of the humeral head. The articular cartilage damage area of the glenoid was correlated with that of the humeral head. In conclusion, the area of glenohumeral degeneration was greater in the rotator cuff tear group and was located in a specific site. Reproduced with permission from Acta Orthopaedica Scandinavica. 74(1):89-94,

Determination of in vivo glenohumeral translation using fluoroscopy and shape-matching techniques

“…Active translation of the humeral head away from the glenoid center likely is indicative of insufficient passive and/or active stabilization, and is causative of gradual joint degeneration due to local articular cartilage and labrum overload. 1,4,8,10,13,18 Additional work is required to understand the mechanisms providing glenohumeral stability during dynamic motion. We believe 3D fluoroscopic analysis of shoulder kinematics can, and will, provide information important for improved understanding of shoulder function and that this information may lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.…”

Effect of supraspinatus deficiency on humerus translation and glenohumeral contact force during abduction

“…This disease can affect all muscles of the rotator cuff, but the supraspinatus is almost always involved, and the tear is often limited to it. Rotator cuff tear is clinically associated to pain and functional disability, and also to higher osteoarthritis occurrence (Hsu et al, 2003). From a biomechanical point of view, the main consequence of a rotator cuff tear is a loss of stability, which results in a higher upward migration of the humeral head during abduction, and possible impingement with the acromion (Kaneko et al, 1995;Weiner and Macnab, 1970).…”

Determination of <i>In-vivo</i> Glenohumeral Translation during Loaded and Unloaded Arm Elevation

“…Greater centering and joint contact forces are developed with increased abduction, thus a stable joint provides ef cient linkage for the rotator cuff with the deltoid muscle and scapular function in elevated postures. Active translation of the humeral head away from the glenoid center could therefore indicate insuf cient passive and/or active stabilization and is likely causative of gradual joint degeneration due to local articular cartilage and labrum overload 20,[22][23][24][25][26][27] . Further studies are clearly required to fully understand the mechanisms providing glenohumeral stability during dynamic motion, and we believe 3D uoroscopic analysis of shoulder kinematics can and will provide such information about shoulder function.…”