The Rotator Cable Does Not Stress Shield the Crescent Area During Shoulder Abduction

Schmidt, Christopher C.; Spicer, Christopher S.; Papadopoulos, Dimitrios V.; Delserro, Sean; Tomizuka, Yoshiaki; Zink, Thomas R.; Blake, Ryan J.; Smolinski, Michael P.; Miller, Mark Carl; Greenwell, James M; Carrazana-Suarez, Luis F.; Smolinski, Patrick

doi:10.2106/jbjs.21.01142

Cited by 3 publications

(4 citation statements)

References 48 publications

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“…Previous research has demonstrated the role of the crescent region in transmitting muscle-generated loads during shoulder abduction 9 , consistent with our findings. We observed significantly higher strains in the anterior third of the rotator cable compared with the middle and posterior thirds, with no significant strain difference between the anterior third and the crescent region during loading of the whole SSP muscle.…”

Section: Discussionsupporting

confidence: 93%

“…Cadaveric studies have investigated the strain distribution in the bursal (superficial) surfaces of the rotator cable and crescent 2,9,10 . Mesiha et al demonstrated increased strains in preserved superficial SSP tendon regions when the anterior insertion of the rotator cable was torn, emphasizing the role of the anterior insertion as the primary load-bearing structure 2 .…”

Section: Discussionmentioning

confidence: 99%

“…The biomechanics and functional roles of the rotator cuff tendons have been explored through assessments of superficial tendon strain distribution in cadaveric shoulders under muscle tension 2,[6][7][8][9][10] . However, recent anatomical studies have revealed that the rotator cuff muscles, particularly the SSP and ISP muscles, consist of deep and superficial regions, distinguished on the basis of their depth within the muscle structure 11,12 .…”

mentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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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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“…3 ). 30 , 39 The modeling software was used to quantify the length and width of the tendon footprints and the intact and torn footprint areas. The caliper measurements of length and width were compared to computer-generated values to validate the 3D modeling.…”

Section: Methodsmentioning

confidence: 99%