Which shoulder motions cause subacromial impingement? Evaluating the vertical displacement and peak strain of the coracoacromial ligament by ultrasound speckle tracking imaging

Park, In; Kim, Sungeun; Bae, Sung-Ho; Byun, Chu-Hwan; Kim, Yang-Soo

doi:10.1016/j.jse.2015.04.001

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…Subacromial impingement occurs most frequently in abduction, and is exacerbated by internal rotation. 48 , 58 , 59 , 61 Our results are consistent with these observations, as we found a positive correlation between the proportion of impinging bone removed and improvements in internal rotation with the arm at 90° of abduction. In fact, our results suggest that complete removal of impinging bone could improve internal rotation by up to 27°.…”

Section: Discussionsupporting

confidence: 91%

Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone

et al. 2020

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Background To date, there is no consensus on when and how to perform acromioplasty during rotator cuff repair (RCR). We aimed to determine the volume of impinging bone removed during acromioplasty and whether it influences postoperative range of motion (ROM) and clinical scores after RCR. Methods Preoperative and postoperative computed tomography scans of 57 shoulders that underwent RCR were used to reconstruct scapula models to simulate volumes of impinging acromial bone preoperatively and then compare them to the volumes of bone resected postoperatively to calculate the proportions of desired (ideal) vs. unnecessary (excess) resections. All patients were evaluated preoperatively and at 6 months to assess ROM and functional scores. Results The volume of impinging bone identified was 3.5 ± 2.3 cm 3 , of which 1.6 ± 1.2 cm 3 (50% ± 27%) was removed during acromioplasty. The volume of impinging bone identified was not correlated with preoperative critical shoulder angle ( r = 0.025, P = .853), nor with glenoid inclination ( r = −0.024, P = .857). The volume of bone removed was 3.7 ± 2.2 cm 3 , of which 2.1 ± 1.6 cm 3 (53% ± 24%) were unnecessary resections. Multivariable analyses revealed that more extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction (beta, 27.5, P = .048) but did not affect other shoulder movements or clinical scores. Conclusions Acromioplasty removed only 50% of the estimated volume of impinging acromial bone. More extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction.

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Section: Discussionsupporting

confidence: 91%

Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone

et al. 2020

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“…During shoulder elevation, the supraspinatus tendon acts as an important humeral head depressor, allowing the proximal humerus to pass underneath the acromion322. The LHBT works synergistically with the supraspinatus tendon and is vulnerable to tensile stress with impingement5.…”

Section: Discussionmentioning

confidence: 99%

Association of Bicipital Peritendinous Effusion with Subacromial Impingement: A Dynamic Ultrasonographic Study of 337 Shoulders

Chang

Özçakar

2016

Sci Rep

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Bicipital peritendinous effusion (BPE) is the most common biceps tendon abnormality and can be related to various shoulder ultrasonographic findings. Since the association of BPE with subacromial impingement is unclear, our study aimed to explore its association with the dynamic subacromial impingement test during ultrasound (US) imaging. We included 337 shoulders referred for US examinations and quantified the amount of BPE. Effusion more than 1 mm in thickness was considered a positive finding. A comparison of three grades of subacromial impingement, adjusted by patient demographics, static sonographic shoulder pathology, and physical findings, by using multivariate regression models revealed that the odds ratio of subacromial impingement (with 95% confidence intervals) in the presence of BPE was 6.54 (3.21–13.32) in grade 1, 6.93 (3.05–15.76) in grade 2 and 3.18 (1.48–6.80) in grade 3. An increase in age, subdeltoid bursitis, full-thickness supraspinatus tendon tear, and shoulder stiffness were also associated with BPE. Since our study demonstrated a positive association of BPE with all grades of impingement, a US dynamic subacromial impingement test is suggested when BPE is present. Future prospective studies are needed to identify changes in BPE after treatment.

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“…95 Then, automated speckle tracking algorithms are used to calculate the frame-to-frame speckle displacement within the ROI, which is then converted into tendon elongations. 50,134…”

Section: Measurement Technology and Experimental Methodsmentioning

confidence: 99%

“…119 Using speckle-tracking, 5-7% strains were observed in the coracoacromial ligament during dynamic shoulder rotations such as forward flexion, horizontal abduction, and internal rotation at 90°abduction. 134 The strain patterns and displacements of the coracoacromial ligament indicated contact with the rotator cuff in these frequently used shoulder movements. This indicates a possible mechanism for rotator cuff pathologies, and provides guidelines for rehabilitation protocols as certain movements such as forward flexion, horizontal abduction, and internal rotation at 90°abduction were found to induce excessive tissue strains.…”

Section: Key Findingsmentioning

confidence: 98%

“…Implantable strain sensors have largely been applied to measure in vivo ACL strains, 17,44,140 but such technologies have mostly been implemented during controlled movements and in sterile surgical environments. The virtual fibre elongation method uses bone position from image-based methods including fluoroscopy, 87,166,181 ultrasound, 134 open magnetic resonance imaging (open-MRI), 64,91 or computed tomography (CT) 60,161 to derive in vivo ligament and tendon strains. Ultrasound technique enables dynamic non-invasive planar imaging of soft tissue structures, and has mostly been applied to measure muscle 33,105 and tendon 126,159 deformation.…”

Section: Introductionmentioning

confidence: 99%

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Techniques for In Vivo Measurement of Ligament and Tendon Strain: A Review

et al. 2020

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The critical clinical and scientific insights achieved through knowledge of in vivo musculoskeletal soft tissue strains has motivated the development of relevant measurement techniques. This review provides a comprehensive summary of the key findings, limitations, and clinical impacts of these techniques to quantify musculoskeletal soft tissue strains during dynamic movements. Current technologies generally leverage three techniques to quantify in vivo strain patterns, including implantable strain sensors, virtual fibre elongation, and ultrasound. (1) Implantable strain sensors enable direct measurements of tissue strains with high accuracy and minimal artefact, but are highly invasive and current designs are not clinically viable. (2) The virtual fibre elongation method tracks the relative displacement of tissue attachments to measure strains in both deep and superficial tissues. However, the associated imaging techniques often require exposure to radiation, limit the activities that can be performed, and only quantify bone-to-bone tissue strains. (3) Ultrasound methods enable safe and non-invasive imaging of soft tissue deformation. However, ultrasound can only image superficial tissues, and measurements are confounded by out-of-plane tissue motion. Finally, all in vivo strain measurement methods are limited in their ability to establish the slack length of musculoskeletal soft tissue structures. Despite the many challenges and limitations of these measurement techniques, knowledge of in vivo soft tissue strain has led to improved clinical treatments for many musculoskeletal pathologies including anterior cruciate ligament reconstruction, Achilles tendon repair, and total knee replacement. This review provides a comprehensive understanding of these measurement techniques and identifies the key features of in vivo strain measurement that can facilitate innovative personalized sports medicine treatment.

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Which shoulder motions cause subacromial impingement? Evaluating the vertical displacement and peak strain of the coracoacromial ligament by ultrasound speckle tracking imaging

Cited by 15 publications

References 28 publications

Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone

Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone

Association of Bicipital Peritendinous Effusion with Subacromial Impingement: A Dynamic Ultrasonographic Study of 337 Shoulders

Techniques for In Vivo Measurement of Ligament and Tendon Strain: A Review

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