Skip to main content
SpringerLink
Log in

Passive contribution of the rotator cuff to abduction and joint stability

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study is to compare shoulder joint biomechanics during abduction with and without intact non-functioning rotator cuff tissue.

Methods

A cadaver model was devised to simulate the clinical findings seen in patients with a massive cuff tear. Eight full upper limb shoulder specimens were studied. Initially, the rotator cuff tendons were left intact, representing a non-functional rotator cuff, as seen in suprascapular nerve paralysis or in cuff repair with a patch. Subsequently, a massive rotator cuff tear was re-created. Three-dimensional kinematics and force requirements for shoulder abduction were analyzed for each condition using ten abduction cycles in the plane of the scapula.

Results

Mediolateral displacements of the glenohumeral rotation center (GHRC) during abduction with an intact non-functioning cuff were minimal, but massive cuff tear resulted in significant lateral displacement of the GHRC (p < 0.013). Similarly, massive cuff tear caused increased superior migration of the GHRC during abduction compared with intact non-functional cuff (p < 0.01). From 5 to 30° of abduction, force requirements were significantly less with an intact non-functioning cuff than with massive cuff tear (p < 0.009).

Conclusion

During abduction, an intact but non-functioning rotator cuff resulted in decreased GHRC displacement in two axes as well as lowered the force requirement for abduction from 5 to 30° as compared with the results following a massive rotator cuff tear. This provides insight into the potential biomechanical effect of repairing massive rotator cuff tears with a biological or synthetic “patch,” which is a new treatment for massive cuff tear.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. An KN, Browne AO, Korinek S, Tanaka S, Morrey BF et al (1991) Three-dimensional kinematics of glenohumeral elevation. J Orthop Res 9(1):143–149

    Article  PubMed  CAS  Google Scholar 

  2. Arntz CT, Jackins S, Matsen FA (1993) Prosthetic replacement of the shoulder for the treatment of defects in the rotator cuff and the surface of the glenohumeral joint. J Bone Jt Surg Am 73(4):485–491

    Google Scholar 

  3. Billuard F, Devun L, Skalli W, Mitton D, Gagey O (2008) Role of the deltoid and passive elements in stabilization during abduction motion (0–40°): annex vivo study. Surg Radiol Anat 30:563–568

    Article  Google Scholar 

  4. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F (2005) Grammont reverse prosthesis: design, rationale, and biomechanics. J Should Elb Surg 14(1 Suppl S):147S–161S

    Article  Google Scholar 

  5. Burkhart SS (1992) Fluoroscopic comparison of kinematic patterns in massive rotator cuff tears. A suspension bridge model. Clin Orthop Relat Res 284:144–152

    PubMed  Google Scholar 

  6. Debski RE, McMahon PJ, Thompson WO, Woo SL-Y, Warner JJ-P, Fu FH (1995) A new dynamic testing apparatus to study glenohumeral joint motion. J Biomech 28(7):869–874

    Article  PubMed  CAS  Google Scholar 

  7. Debski RE, Sakone M, Woo SL, Wong EK, Fu FH, Warner JJ (1999) Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading. J Should Elb Surg 8(4):324–329

    Article  CAS  Google Scholar 

  8. Field LD, Dines DM, Zabinski SJ et al (1997) Hemiarthroplasty of the shoulder for rotator cuff arthropathy. J Should Elb Surg 6(1):18–23

    Article  CAS  Google Scholar 

  9. Gerber C, Blumenthal S, Curt A, Werner CML (2007) Effect of selective experimental suprascapular nerve block on abduction and external rotation strength of the shoulder. J Should Elb Surg 16(6):815–820

    Article  Google Scholar 

  10. Halder AM, Zhao KD, O’Driscoll SW, Morrey BF, An KN (2001) Dynamic contributions to superior shoulder stability. J Orthop Res 19(2):206–212

    Article  PubMed  CAS  Google Scholar 

  11. Halder AM, Halder CG, Zhao KD, O’Driscoll SW, Morrey BF, An KN (2001) Dynamic inferior stabilizers of the shoulder joint. Clin Biomech (Bristol, Avon) 16(2):138–143

    Article  CAS  Google Scholar 

  12. Karduna AR, Williams GR, Williams JL, Iannotti JP (1996) Kinematics of the glenohumeral joint: influences of muscle forces, ligamentous constraints, and articular geometry. J Orthop Res 14(6):986–993

    Article  PubMed  CAS  Google Scholar 

  13. Kelkar R, Wang VM, Flatow EL, Newton PM et al (2001) Glenohumeral mechanics: a study of articular geometry, contact, and kinematics. J Should Elb Surg 10(1):73–84

    Article  CAS  Google Scholar 

  14. Levasseur A, Tétreault P, de Guise J, Nuño N, Hagemeister N (2007) The effect of axis alignment on shoulder joint kinematics analysis during arm abduction. Clin Biomech (Bristol, Avon) 22(7):758–766

    Article  Google Scholar 

  15. Liu J, Hughes RE, Smutz WP, Niebur G, An KN (1997) Roles of deltoid and rotator cuff muscles in shoulder elevation. Clin Biomech (Bristol, Avon) 12(1):32–38

    Article  CAS  Google Scholar 

  16. Loehr JF, Helmig P, Sojbjerg J-O, Jung A (1994) Shoulder instability caused by rotator cuff lesions. An in vitro study. Clin Orthop Relat Res 304:84–90

    Google Scholar 

  17. Meskers CGM, van der Helm FCT, Rozendaal LA, Rozing PM (1998) In vivo estimation of the glenohumeral joint rotation center from scapular bony landmarks by linear regression. J Biomech 31(1):93–96

    Article  PubMed  CAS  Google Scholar 

  18. Neer CS, Craig EV, Fukuda H (1983) Cuff-tear arthropathy. J Bone Jt Surg Am 65(9):1232–1244

    Google Scholar 

  19. Ovesen J, Nielsen S (1986) Anterior and posterior shoulder instability. A cadaver study. Acta Orthop Scand 57(4):324–327

    Article  PubMed  CAS  Google Scholar 

  20. Parsons IM, Apreleva M, Fu FH, Woo SL-Y (2002) The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res 20(3):439–446

    Article  PubMed  CAS  Google Scholar 

  21. Sclamberg SG, Tibone JE, Itamura JM, Kasraeian S (2004) Six-month magnetic resonance imaging follow-up of large and massive rotator cuff repairs reinforced with porcine small intestinal submucosa. J Should Elb Surg 13(5):538–541

    Article  Google Scholar 

  22. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Jt Surg Br 86(3):388–395

    Article  CAS  Google Scholar 

  23. Thompson WO, Debski RE, Boardman ND, Taskiran E, Warner JJ-P, Fu FH, Woo SL-Y (1996) A biomechanical analysis of rotator cuff deficiency in a cadaveric model. Am J Sports Med 24(3):286–292

    Article  PubMed  CAS  Google Scholar 

  24. Visotsky JL, Basamania C, Seebauer L, Rockwood CA, Jensen K (2004) Cuff tear arthropathy: pathogenesis, classification, and algorithm for treatment. J Bone Jt Surg Am 86-A(Suppl 2):35–40

    Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge the financial support of NSERC, FQRNT, FRSQ, and the CHUM- Department of Orthopaedic Surgery. All sources of funding had no involvement in the study design, collection and analysis and interpretation of data, writing of the manuscript, or decision to submit the manuscript for publication.

Conflicts of interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Laboratoire de recherche en imagerie et orthopédie, Centre de recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, Canada

    Patrice Tétreault, Annie Levasseur, Jacques de Guise, Natalia Nuño & Nicola Hagemeister

  2. École de technologie supérieure, Montreal, Canada

    Jacques de Guise, Natalia Nuño & Nicola Hagemeister

  3. Université de Montréal, Montreal, Canada

    Annie Levasseur

  4. Orthopedic Surgery, Hôpital Notre-Dame, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, Canada

    Patrice Tétreault

  5. Plastic Surgery, CHU Sainte-Justine, Montreal, Canada

    Jenny C. Lin

  6. Service d’orthopédie, bureau DR-1118-16, CHUM—Hôpital Notre-Dame, 1560 rue Sherbrooke, Montréal, QC, H2L 4M1, Canada

    Patrice Tétreault

Authors
  1. Patrice Tétreault
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annie Levasseur
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jenny C. Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacques de Guise
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natalia Nuño
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicola Hagemeister
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrice Tétreault.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tétreault, P., Levasseur, A., Lin, J.C. et al. Passive contribution of the rotator cuff to abduction and joint stability. Surg Radiol Anat 33, 767–773 (2011). https://doi.org/10.1007/s00276-011-0807-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-011-0807-9

Keywords

Search

Navigation