Dynamic Analysis of the Coracohumeral Ligament Using Ultra-Sonography in Shoulder Contracture

Abstract

The coracohumeral ligament (CHL) is related to the range of motion of the shoulder joint. The evaluation of the CHL using ultrasonography (US) has been reported on the elastic modulus and thickness of the CHL, but no dynamic evaluation method has been established. We aimed to quantify the movement of the CHL by applying Particle Image Velocimetry (PIV), a technique used in the field of fluid engineering, to cases of shoulder contracture using the US. The subjects were eight patients, with 16 shoulders. The coracoid process was identified from the body surface, and a long-axis US image of the CHL parallel to the subscapularis tendon was drawn. The shoulder joint was moved from 0 degrees of internal/external rotation to 60 degrees of internal rotation at a rhythm of one reciprocation every 2 s. The velocity of the CHL movement was quantified by the PIV method. The mean magnitude velocity of CHL was significantly faster on the healthy side. The maximum magnitude velocity was significantly faster on the healthy side. The results suggest that the PIV method is helpful as a dynamic evaluation method, and in patients with shoulder contracture, the CHL velocity was significantly decreased.

Investigation of the limiting factors of shoulder joint complex motion in college baseball players: motion analysis of the humeral head and rotator cuff using ultrasound

“…Previous reports have shown ICCs of 0.810 for humeral head translation in patients with shoulder instability 9 and 0.80 for the velocity of coracohumeral ligament in patients with frozen shoulder. 11 Therefore, the measurement method employed in the present study was capable of accurately calculating humeral head translation and ISP velocity. Furthermore, the differences observed between the throwing and nonthrowing sides were approximately 2.5 mm for D AT and approximately 0.20 mm/s for the mean ISP velocity during IR.…”

“…To determine the sample size, a power analysis was conducted using G∗Power 3.1.9 (Heinrich Heine Universität, Düsseldorf, Germany) based on a previous report that analyzed the velocity of soft tissue in the shoulder using PIV and compared both sides. 11 Sample size calculations indicated that a sample size of 12 participants would be sufficient to detect differences using a t test (effect size, d = 0.8; significance level, α = 0.05; power, 0.8).…”

“…Initially, the shoulder was moved from 0 to 60 degrees of IR, following a rhythm of one repetition every 2 seconds, guided by a metronome. 11 We then used PIV fluid measurement software (PIVlab, Version 2.36, an add-in software from MATLAB 2021, MathWorks, Natick, MA, USA) to analyze the velocity of ISP motion. 29 , 30 To facilitate analysis, we divided all the ultrasound movies into 30 static images per second.…”

“…Furthermore, particle image velocimetry (PIV), a fluid engineering technique capable of visualizing fluid velocity, has garnered attention in the orthopedic field for dynamic analysis. 11 , 12 , 25 , 28 In orthopedics, PIV has been used to investigate the relationship between fascial gliding and postoperative pain after proximal femoral fracture surgery. 12 Additionally, the PIV technique has been applied in patients with frozen shoulders, revealing decreased coracohumeral ligament velocity during shoulder IR and ER 11 and decreased velocity, indicating decreased flexibility of the tissue.…”

“… 11 , 12 , 25 , 28 In orthopedics, PIV has been used to investigate the relationship between fascial gliding and postoperative pain after proximal femoral fracture surgery. 12 Additionally, the PIV technique has been applied in patients with frozen shoulders, revealing decreased coracohumeral ligament velocity during shoulder IR and ER 11 and decreased velocity, indicating decreased flexibility of the tissue. Consequently, the use of the PIV method for ultrasonography allows for dynamic evaluation of tendons and ligaments, and we believe that PIV could also be applied in the assessment of rotator cuff muscles.…”