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Evaluation of rotator cuff abduction moment arms for superior capsular reconstruction and reverse total shoulder arthroplasty

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Abstract

Purpose

The rotator cuff (RC) muscles contribute to dynamic stability and rotational actions of the glenohumeral joint. Moment arm can be used to demonstrate the potential work a muscle contributes to a musculoskeletal joint rotation. This study aimed to understand the moment arm contributions of the RC muscles and explore changes following a complete supraspinatus tear treated with either superior capsular reconstruction (SCR) or reverse total shoulder arthroplasty (rTSA).

Methods

Five fresh-frozen cadaveric specimens were prepared and mounted in an apparatus where each intact RC muscle was held in tension with a line of action toward its origin on the scapula. Mean moment arms for each muscle were determined experimentally based on Optotrak data collected during cadaveric shoulder arm abduction.

Results

Using ANOVA testing, our analysis demonstrated significant differences (p < 0.001) in infraspinatus and teres minor moment arms after rTSA compared to the intact shoulder model. After SCR, significant differences (p < 0.001) were seen in teres minor, with these differences being statistically similar to the changes seen in teres minor after rTSA. Subscapularis showed no significant difference in moment arm values between the models (p = 0.148).

Conclusion

Our results illustrate that mean moment arms were preserved in the RC muscles after complete supraspinatus tear. This study also shows evidence that subscapularis function may be maintained after SCR or rTSA. After SCR, infraspinatus may maintain similar abduction ability compared to the anatomical shoulder, while teres minor ability may increase. Infraspinatus may have decreased abduction ability after rTSA while teres minor may have increased ability.

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Acknowledgements

We thank Sarah Davis for the original drawings from Figs. 1 and 2.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Illinois, 835 S. Wolcott Avenue, E270 MSS MC 844, Chicago, IL, 60612, USA

    Martine T. Dolan, Michael J. Patetta, Sonia Pradhan, Dmitriy Peresada, Danil Rybalko, Aimee Bobko, Benjamin A. Goldberg & Farid Amirouche

  2. Department of Orthopaedic Surgery, Orthopaedic and Spine Institute, Northshore University HealthSystem an Affiliate of University of Chicago Pritzker School of Medicine, 2650 Ridge Avenue, Suite 2505, Walgreen Building, Evanston, IL, 60201, USA

    Jason L. Koh & Farid Amirouche

  3. Department of Orthopaedics, Shoulder and Elbow Surgery, MC3079, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Jason L. Koh & Lewis Shi

Authors
  1. Martine T. Dolan
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  2. Michael J. Patetta
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  3. Sonia Pradhan
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  4. Dmitriy Peresada
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  5. Danil Rybalko
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  6. Aimee Bobko
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  7. Jason L. Koh
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  8. Lewis Shi
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  9. Benjamin A. Goldberg
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  10. Farid Amirouche
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Sonia Pradhan, Michael J. Patetta, and Dmitriy Peresada. The first draft of the manuscript was written by Sonia Pradhan and Martine Dolan, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Benjamin A. Goldberg.

Ethics declarations

Ethics approval

All aspects of this study are in accordance with the ethical standards in the 1964 Declaration of Helsinki, relevant regulations of the US Health Insurance Portability, and regulations of the Accountability Act (HIPAA).

Consent for publication

All experimentation, data collection, and analysis were performed at the University of Illinois Hospital & Health Sciences System in Chicago, Illinois.

Conflict of interests

Jason Koh has the following commercial associations to disclose: Acuitive: paid consultant, stock or stock options; American Shoulder and Elbow Surgeons: board or committee member; Arthroscopy Association of North America: board or committee member; Flexion: paid consultant; Herodicus Society: board or committee member; International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: board or committee member; Marrow Access Technologies: employee, stock or stock options, patent holder; and Orthopaedic Journal of Sports Medicine/AOSSM: editorial or governing board. Benjamin Goldberg has the following commercial associations to disclose: Acumed, LLC: paid consultant; paid presenter or speaker; Allen Medical: paid consultant; paid presenter or speaker; Aston: paid consultant; paid presenter or speaker; Aston Medical: IP royalties; European Journal of Orthopaedic Surgery and Traumatology (EJOST): editorial or governing board; Medwest/Arthrex: paid consultant; paid presenter or speaker; and Stryker: paid consultant; paid presenter or speaker. All other authors declare no competing interests.

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Dolan, M.T., Patetta, M.J., Pradhan, S. et al. Evaluation of rotator cuff abduction moment arms for superior capsular reconstruction and reverse total shoulder arthroplasty. International Orthopaedics (SICOT) 45, 1767–1774 (2021). https://doi.org/10.1007/s00264-021-05066-6

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  • DOI: https://doi.org/10.1007/s00264-021-05066-6

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