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Rotator cuff tear reaching the superior half portion of the humeral head causes shoulder abduction malfunction

Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To examine the biomechanical properties governing posterosuperior rotator cuff (RC) tear progression and dynamic shoulder abduction function, in the absence of excess loading.

Methods

Twelve freshly frozen cadaveric shoulders were evaluated via an established dynamic shoulder abduction stimulator. The shoulder abduction functions were primarily evaluated using subacromial contact pressure (SACP) during an abduction procedure, and subsequent middle deltoid force (MDF) under 5 conditions: (1) intact, (2) anterior 1/3 posterosuperior rotator cuff (PSRC) tear, (3) anterior 2/3 PSRC tear, (4) entire PSRC tear, and (5) global RC tear (tear involving the entire superior RC).

Results

No obvious differences were observed in the peak MDF required for abduction, and in the peak SACP among the four PSRC tear statuses (49.8 ± 9.2 N, 0.39 ± 0.05 mPa [1/3 PSRC tear]; 49.3 ± 6.8 N, 0.40 ± 0.06 mPa [2/3 PSRC tear]; 51.6 ± 7.0 N, 0.44 ± 0.08 mPa [entire PSRC tear]), as well as intact statuses (48.3 ± 9.8 N, 0.40 ± 0.05 mPa). However, significant elevations in the peak MDF and peak SACP levels were observed among the four PSRC tear statuses and global RC tear (68.1 ± 9.3 N; 4.12 ± 1.50 mPa, P < 0.01).

Conclusion

In the absence of excess loading, the biomechanical function of the shoulder was not impaired by a simple PSRC tear. However, once the tear size reached the half superior portion of the humeral head, the humeral head migrated to the surface of the subacromion, and this action markedly decreased shoulder abduction function.

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Data availability

Original data could be properly requested through e-mail.

Abbreviations

RC:

Rotator cuff

PSRC:

Posterosuperior rotator cuff

MDF:

Deltoid force

SACP:

Peak subacromial contact pressure

SACA:

Subacromial contact area

SACF:

Subacromial contact force

GHCF:

Glenohumeral contact force

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Funding

National Natural Science Foundation of China (81902186, 81671920, 31972923, 81871753, 81772341) National Key Research and Development Program of China (Grant No. 2018YFC1106200, 2018YFC1106201, 2018YFC1106202) Technology Support Project of Science and Technology Commission of Shanghai Municipality of China (19441901700, 19441901701, 19441901702, 18441902800, 21S31908500, 19441902500) The funding source did not play a role in the investigation.

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Authors

Contributions

LW: conceptualization; data curation; formal analysis; investigation; methodology; project administration; writing-original draft; writing-review and editing. YK: conceptualization; data curation; formal analysis; investigation; writing and editing. YW: data curation; formal analysis; methodology. MW: data curation; formal analysis; methodology. HG: Data curation; formal analysis; methodology. DS: data curation; formal analysis; methodology. GX: supervision; methodology. SY: funding acquisition; supervision. JJ: conceptualization; funding acquisition; supervision; methodology. JZ: conceptualization; methodology; investigation; project administration; resources; supervision; writing-review and editing.

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Correspondence to Jia Jiang or Jinzhong Zhao.

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Wang, L., Kang, Y., Wei, Y. et al. Rotator cuff tear reaching the superior half portion of the humeral head causes shoulder abduction malfunction. Knee Surg Sports Traumatol Arthrosc 31, 1865–1872 (2023). https://doi.org/10.1007/s00167-022-07044-w

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