Changes in shoulder muscle activities and glenohumeral motion after rotator cuff repair: an assessment using ultrasound real-time tissue elastography

Ishikawa, Hiroaki; Muraki, Takayuki; Morise, Shuhei; Kurokawa, Daisuke; Yamamoto, Nobuyuki; Itoi, Eiji; Izumi, Shin-ichi

doi:10.1016/j.jse.2021.04.013

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…3,15 Several in vivo methods for measuring the humeral head translation and capsular tension have been described; however, they have not been used for analyzing the postoperative effects of passive and active stabilizers in patients receiving RMBR in the anterior dislocation-prone position. 30,32,38,[51][52][53] This study quantified the glenohumeral translation and capsular tissue tension to evaluate glenohumeral stability after RMBR in the resting ABER and muscle-active ABER states using MRI 3D postprocessing techniques and ultrasonic SWE. Multiple scans were captured to avoid the disadvantages of previous in vivo radiographic studies.…”

Section: Discussionmentioning

confidence: 99%

Stabilizing Mechanisms in Patients Treated Using Hill-Sachs Remplissage With Bankart Repair in Abduction–External Rotation Position

Zhang,

Liao,

Chen

et al. 2024

Am J Sports Med

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Background: Hill-Sachs lesion (HSL) remplissage with Bankart repair (RMBR) provides a minimally invasive solution for treating HSLs and glenoid bone defects of <25%. The infraspinatus tendon is inserted into the HSL during the remplissage process, causing the infraspinatus to shift medially, leading to an unknown effect on glenohumeral alignment during the resting abduction–external rotation (ABER) and muscle-active states. Purpose/Hypothesis: The purpose of this study was to evaluate the possible check-rein effect and muscle-active control in stabilizing the glenohumeral joint after RMBR in vivo. We hypothesized that the check-rein effect and active control would stabilize the glenohumeral joint in the ABER position in patients after RMBR. Study Design: Controlled laboratory study. Methods: We included 42 participants—22 patients in group A who met the inclusion criteria after RMBR and 20 healthy participants in group B without shoulder laxity. Three-dimensional magnetic resonance imaging was performed to analyze the alignment relationship of the glenohumeral joint with and without muscular activity. Ultrasonic shear wave elastography was used to evaluate the elastic properties of the anterior capsule covered with the anterior bands of the inferior glenohumeral ligament. Results: Patients who underwent RMBR demonstrated more posterior (–1.81 ± 1.19 mm vs –0.76 ± 1.25 mm; P = .008) and inferior (–1.05 ± 0.62 mm vs –0.45 ± 0.48 mm; P = .001) shifts of the humeral head rotation center and less anterior capsular elasticity (70.07 ± 22.60 kPa vs 84.01 ± 14.08 kPa; P = .023) than healthy participants in the resting ABER state. More posterior (–3.17 ± 0.84 mm vs –1.81 ± 1.19 mm; P < .001) and less-inferior (–0.34 ± 0.56 mm vs –1.05 ± 0.62 mm; P < .001) shifts of the humeral head rotation center and less anterior capsular elasticity (36.57 ± 13.89 kPa vs 70.07 ± 22.60 kPa; P < .001) were observed in the operative shoulder during muscle-active ABER than in resting ABER states. Conclusion: The check-rein effect and muscle-active control act as stabilizing mechanisms in RMBR during the ABER position. Clinical Relevance: Stabilizing mechanisms in RMBR during the ABER position include the check-rein effect and muscle-active control.

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Section: Discussionmentioning

confidence: 99%

Stabilizing Mechanisms in Patients Treated Using Hill-Sachs Remplissage With Bankart Repair in Abduction–External Rotation Position

Zhang,

Liao,

Chen

et al. 2024

Am J Sports Med

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“…For the SSP muscle, Sakaki et al 23 reported that the shear modulus of the anterior deep region was lower in the repaired shoulder than in the contralateral unaffected shoulder during contraction 6 months postsurgery, although a regional difference in shear modulus change was observed. Furthermore, Ishikawa et al 43 reported that the muscle strain ratio of patients with repair was higher (i.e., muscle was less stiff) than that of the control during abduction 6 weeks postsurgery but recovered with postoperative duration; these authors also evaluated synergist muscles. It has been reported that there is no difference in the shear moduli of UT and MD muscles between repaired and contralateral unaffected shoulders during abduction throughout pre‐ and postoperative duration 23 and between the patient and control in MD muscle strain ratio 3 months after surgery 43 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Ishikawa et al 43 reported that the muscle strain ratio of patients with repair was higher (i.e., muscle was less stiff) than that of the control during abduction 6 weeks postsurgery but recovered with postoperative duration; these authors also evaluated synergist muscles. It has been reported that there is no difference in the shear moduli of UT and MD muscles between repaired and contralateral unaffected shoulders during abduction throughout pre‐ and postoperative duration 23 and between the patient and control in MD muscle strain ratio 3 months after surgery 43 . Another study described the mechanical properties of the SSP muscle under passive conditions; however, other synergist muscles have not been studied in this regard.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that there is no difference in the shear moduli of UT and MD muscles between repaired and contralateral unaffected shoulders during abduction throughout pre-and postoperative duration 23 and between the patient and control in MD muscle strain ratio 3 months after surgery. 43 Another study described the mechanical properties of the SSP muscle under passive conditions; however, other synergist muscles have not been studied in this regard. Itoigawa et al 22 showed that the shear modulus decreased in the first few months and then progressively improved 4 months after surgery.…”

Section: F I G U R E 4 Individual Analysis For the Compensation Strat...mentioning

confidence: 99%

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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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“…Real-time tissue elastography (RTE) has been widely used to assess muscle contractile activity. 11 , 12 , 17 , 19 , 31 , 32 , 33 , 34 This technique allows for noninvasive estimations of tissue elasticity during muscle contraction, as a surrogate for activity, by measuring strain wave propagation within the tissue. Previous studies have implemented RTE presurgical and postsurgical repair of torn supraspinatus tendons to evaluate muscle contractility showing excellent reliability and determining the feasibility of contractility as a predictor for muscle quality and function.…”

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confidence: 99%

Muscle belly ratio is the most suitable estimate of the activity of the torn supraspinatus muscle

Hoshikawa¹,

Yuri²,

Oishi³

et al. 2023

JSES International

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Changes in shoulder muscle activities and glenohumeral motion after rotator cuff repair: an assessment using ultrasound real-time tissue elastography

Cited by 8 publications

References 36 publications

Stabilizing Mechanisms in Patients Treated Using Hill-Sachs Remplissage With Bankart Repair in Abduction–External Rotation Position

Stabilizing Mechanisms in Patients Treated Using Hill-Sachs Remplissage With Bankart Repair in Abduction–External Rotation Position

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

Muscle belly ratio is the most suitable estimate of the activity of the torn supraspinatus muscle

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