Moment arms from the anatomical subregions of the rotator cuff muscles during flexion

Yuri, Takuma; Trevino, Jose H.; Hooke, Alexander W.; Giambini, Hugo

doi:10.1016/j.jbiomech.2022.111340

Journal of Biomechanics

2022

DOI: 10.1016/j.jbiomech.2022.111340

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Moment arms from the anatomical subregions of the rotator cuff muscles during flexion

Takuma Yuri¹,

Jose H. Trevino²,

Alexander W. Hooke³

et al.

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2024

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Cited by 4 publications

(1 citation statement)

References 21 publications

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“…These findings suggest that tension produced by the deep and superficial regions of the SSP and ISP muscles might distribute unequally, potentially impacting the behavior and function of the rotator cable. This possibility is further supported by studies demonstrating distinct functional roles and biomechanics of the different anatomical regions 15,16 and previous observations indicating distinct intramuscular innervations of these regions 17 . However, the differences in functional and biomechanical characteristics among these anatomical regions and the rotator cable are yet to be determined.…”

supporting

confidence: 70%

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

Yuri,

Prado,

Hoshikawa

et al. 2024

Journal of Bone and Joint Surgery

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Background: The rotator cable functions as a stress and/or load transfer structure. Some studies suggested that a disruption of the cable negatively affects shoulder function and tendon integrity in patients with rotator cuff tears, while others found no functional impairment regardless of rotator cable tear severity. Although anatomical studies have identified distinct regions within the rotator cuff muscles, the strain distribution within the articular sides of the rotator cuff tendons that results from the tension in each region remains unknown. We hypothesized that the posterior region of the supraspinatus (SSP) muscle and the middle region of the infraspinatus (ISP) muscle, with their firm capsular attachments to the cable, transmit 3D strains, and thus tension, to the whole cable, leading to differences in tension within the cable. Methods: The 3D strain distributions in the articular sides of the SSP and ISP tendons of 8 fresh-frozen cadaveric intact shoulders were determined when tension was applied to the various SSP and ISP muscle regions. Results: Loading the anterior SSP muscle region yielded significantly higher strains in the anterior third of the cable compared with the posterior third (p < 0.05). Loading the posterior SSP muscle region yielded no significant differences among the cable and crescent regions. Loading the middle ISP muscle region yielded higher strains in the anterior and posterior thirds of the cable compared with the middle third (p < 0.01). Loading the superior ISP muscle region yielded no significant differences among the cable and crescent regions (p > 0.05). Conclusions: Tension generated from the posterior region of the SSP muscle and middle region of the ISP muscle was evenly distributed to the anterior and posterior attachments of the rotator cable, while the tension generated from other SSP and ISP muscle regions was locally transmitted to the respective attachment area. Clinical Relevance: The rotator cable and crescent serve pivotal roles in transmitting tension generated from the deep regions of the rotator cuff muscles, i.e., the posterior SSP and middle ISP. These findings indicate that both the rotator cable and the rotator crescent play crucial roles as tension transmitters for the deep regions of the rotator cuff muscles. This information could have important implications for developing anatomically relevant repair techniques and enhancing rehabilitation protocols.

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supporting

confidence: 70%

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

Yuri,

Prado,

Hoshikawa

et al. 2024

Journal of Bone and Joint Surgery

Self Cite

View full text Add to dashboard Cite

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Moment arms of the anatomical subregions of the rotator cuff muscles during shoulder rotation

Yuri

Trevino

Hoshikawa

et al. 2023

Clinical Biomechanics

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Muscle Compensation Strategies to Maintain Glenohumeral Joint Stability in Rotator Cuff Tears

Hoshikawa,

Dominguez,

Lawrence

et al. 2024

Journal of Bone and Joint Surgery

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Background: Superior translation of the humeral head is often identified in large and massive rotator cuff (RC) tears. However, the ability of the remaining RC muscles to compensate for the forces causing such superior translation in RC tears remains unclear. The purpose of this study was to investigate the impact of compensatory forces exerted by the remaining RC muscles on humeral head translation using a progressive RC tear model. Methods: Eight fresh-frozen cadaveric shoulders (mean donor age, 57 years) were tested using a custom shoulder testing system. In addition to an intact RC model, 3 RC tear models were created: a supraspinatus tear (Tear I); combined supraspinatus and infraspinatus tears (Tear II); and combined tears of the supraspinatus, infraspinatus, and superior one-third of the subscapularis (Tear III). Compensatory conditions were simulated by increasing the loading of the remaining RC muscles in each RC tear model. Humeral head translation was measured at different abduction and neutral rotation angles in each condition with normal and high deltoid muscle loading. Results: Significant superior translation of the humeral head was observed in Tears II and III (but not Tear I), compared with the intact state, under high loading of the deltoid during abduction and during rotation. In Tear II, compensatory conditions involving increased loading of the teres minor and subscapularis muscles effectively reduced superior translation, so that no significant differences were observed compared with the intact state, even under high deltoid muscle loading. However, in Tear III, significant superior translation was still observed, regardless of the compensatory conditions. Conclusions: ompensation by the remaining RC muscles, particularly the teres minor and subscapularis, effectively reduced superior translation of the humeral head in the posterosuperior RC tear model, whereas this compensatory strategy was insufficient if tears also involved the superior one-third of the subscapularis. Clinical Relevance: Patients with posterosuperior RC tears may find conservative treatment focusing on strengthening the remaining RC muscles, especially the subscapularis and teres minor, to be beneficial. Conversely, patients with repairable massive RC tears also involving the subscapularis tendon may benefit from surgical interventions aimed at primarily repairing the subscapularis tendon to restore the transverse force couple. Massive tears deemed not to be repairable should be evaluated for arthroplasty or other procedures.

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Moment arms from the anatomical subregions of the rotator cuff muscles during flexion

Cited by 4 publications

References 21 publications

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

Moment arms of the anatomical subregions of the rotator cuff muscles during shoulder rotation

Muscle Compensation Strategies to Maintain Glenohumeral Joint Stability in Rotator Cuff Tears

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