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Subacromial Space in African Great Apes and Subacromial Impingement Syndrome in Humans

International Journal of Primatology volume 28, pages 865–880 (2007)Cite this article

Abstract

The subacromial space is the anatomical region limited superiorly by the acromion and the coracoacromial ligament and inferiorly by the glenoid fossa and the humeral head. In humans, the main tissues that form it and that can be affected by subacromial impingement syndrome are the subacromial bursa and the supraspinatus tendon. The syndrome is the most common degenerative pathology affecting the human shoulder, and it is characterized by an uncertain etiopathogenesis. We compared different anatomical parameters of the scapula related to the subacromial impingement syndrome in humans, between modern humans and 2 species of African apes (Pan troglodytes and Gorilla gorilla). The 3 species we studied are orthograde primates and they present a similar structural pattern of the scapula and subacromial space, but anatomical differences exist owing to different types of locomotion used. The main differences indicate that African apes present a more curved and tilted acromion than humans, which does not, however, imply a difference in the relative size of the subacromial space among the 3 species studied. Humans also have a lower value of the relative size of the supraspinatus fossa than African great apes, and in human females have a relative lower value than males. We studied the anatomical structures of the shoulder in African apes that researchers have related to subacromial syndrome in humans to achieve a better understanding of the etiopathogenesis of the syndrome.

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References

  • Aiello, L., & Dean, C. (1990). An Introduction to human evolutionary anatomy. London: Academic Press.

    Google Scholar 

  • Anetzberger, H., Maier, M., Zysk, S., Schulz, C., & Putz, R. (2004). The architecture of the subacromial space after full thickness supraspinatus tears. Zeitschrift für Orthopadie und Ihre Grenzgebiete, 142, 221–227.

    Article  PubMed  CAS  Google Scholar 

  • Aoki, M., Ishii, S., & Usui, M. (1986). The slope of the acromion and rotator cuff impingement. Orthopaeidic Transactions 10, 228.

    Google Scholar 

  • Banas, M. P., Miller, R. J., & Totterman, S. (1995). Relationship between the lateral acromion angle and rotator cuff disease. Journal of Shoulder and Elbow Surgery, 4, 454–461.

    Article  PubMed  CAS  Google Scholar 

  • Bartolozzi, A. R., Andreychik, D., & Ahmad, S. (1994). Determinants of outcome in the treatment of rotator cuff disease. Clinical Orthopaedics and Related Research, 308, 90–97.

    PubMed  Google Scholar 

  • Bigliani, L. U., Morrison, D. S., & April, E. W. (1986). The morphology of the acromion and its relationship to rotator cuff tears. Orthopaedic Transactions, 10, 228.

    Google Scholar 

  • Brox, J. I., Staff, P. H., Ljunggren, A. E., & Brevik, J. I. (1993). Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). British Medical Journal, 307, 899–903.

    PubMed  CAS  Google Scholar 

  • Chard, M. D., Hazleman, R., and Hazleman, B. L. (1991). Shoulder disorders in the elderly: A community survey. Arthritis and Rheumatism, 34, 766–769.

    Article  PubMed  CAS  Google Scholar 

  • Chen, S. K., Simonian, P. T., Wickiewicz, T. L., Otis, J. C., & Warren, R. F. (1999). Radiographic evaluation of glenohumeral kinematics: A muscle fatigue model. Journal of Shoulder and Elbow Surgery, 8, 49–52.

    Article  PubMed  CAS  Google Scholar 

  • Ciochon, R. L., & Corruccini, R. S. (1977). The coracoacromial ligament and projection index in man and other anthropoid primates. Journal of Anatony, 124, 627–632.

    CAS  Google Scholar 

  • Corruccini, R. S., & Ciochon, R. L. (1976). Morphometric affinities of the human shoulder. American Journal of Physical Anthropology, 45, 19–38.

    Article  PubMed  CAS  Google Scholar 

  • Edelson, J. G., & Taitz, C. (1992). Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. Journal of Bone and Joint Surgery, 74, 589–594.

    CAS  Google Scholar 

  • Farley, T. E., Neumann, C. H., Steinbach, L. S., & Petersen, S. A. (1994). The coracoacromial arch: MR evaluation and correlation with rotator cuff pathology. Skeletal Radiology, 23, 641–645.

    Article  PubMed  CAS  Google Scholar 

  • Freese, A. (1998). Anatomische Untersuchungen zur ossären Morphologie und Stellung des Akromions und deren Bedeutung für die Ätiologie des Impingement-Syndroms. Ph.D. Dissertation. University of Aachen.

  • Gohlke, F., Barthel, T., & Gandorfer, A. (1993). The influence of variations of the coracoacromial arch on the development of rotator cuff tears. Archives of Orthopaedic and Trauma Surgery, 113, 28–32.

    Article  PubMed  CAS  Google Scholar 

  • Hashimoto, T., Nobuhara, K., & Hamada, T. (2003). Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clinical Orthopaedics and Related Research, 415, 111–120.

    Article  PubMed  Google Scholar 

  • Hawkins, R. J., & Dunlop, R. (1995). Nonoperative treatment of rotator cuff tears. Clinical Orthopaedics and Related Research, 321, 178–188.

    PubMed  Google Scholar 

  • Howell, S. M., Imobersteg, A. M., Seger, D. H., & Marone, P. J. (1986). Clarification of the role of the supraspinatus muscle in shoulder function. Journal of Bone and Joint Surgery of America, 68, 398–404.

    CAS  Google Scholar 

  • Hyvonen, P., Paivansalo, M., Lehtiniemi, H., Leppilahti, J., & Jalovaara, P. (2001). Supraspinatus outlet view in the diagnosis of stages II and III impngement syndrome. Acta Radiologica, 42, 441–446.

    Article  PubMed  CAS  Google Scholar 

  • Inmann, V. T., Saunders, J. B., & Abbott, L. C. (1944). Observations on the function of the shoulder joint. Journal of Bone and Joint Surgery, 26, 1–30.

    Google Scholar 

  • Jacobson, S. R., Speer, K. P., Moor, J. T., Janda, D. H., Saddemi, S. R., & MacDonald, P. B. (1995). Reliability of radiographic assessment of acromial morphology. Journal of Shoulder and Elbow Surgery, 4, 449–453.

    Article  PubMed  CAS  Google Scholar 

  • Jerosch, J., Castro, W. H., Sons, H. U., & Moesler, M. (1989). Zur Atiologie des subacromialen Impingement-Syndroms- eine biomechanische Untersuchung. Beitrage zür Orthopadie und Traumatologie, 36, 411–418.

    PubMed  CAS  Google Scholar 

  • Jurmain, R. (1989). Trauma, degenerative disease, and other pathologies among the Gombe chimpanzees. American Journal of Physical Anthropology, 80, 229–237.

    Article  PubMed  CAS  Google Scholar 

  • Jurmain, R. (2000). Degenerative joint disease in african great apes: An evolutionary perspective. Journal of Human Evolution, 39, 185–203.

    Article  PubMed  CAS  Google Scholar 

  • Kronberg, M., Nemeth, G., & Brostrom, L. A. (1990). Muscle activity and coordination in the normal shoulder. An electromyographic study. Clinical Orthopaedics and Related Research, 257, 76–85.

    PubMed  Google Scholar 

  • Larson, S. G., & Stern, J. T. (1986). EMG of scapulohumeral muscles in the chimpanzee during reaching and “arboreal” locomotion. American Journal of Anatomy, 176, 171–190.

    Article  PubMed  CAS  Google Scholar 

  • Larson, S. G., & Stern, J. V. (1987). EMG of chimpanzee shoulder muscles during knuckle-walking: Problems of terrestrial locomotion in a suspensory adapted primate. Journal of Zoology London, 212, 629–655.

    Article  Google Scholar 

  • Lehman, C., Cuomo, F., Kummer, F. J., & Zuckerman, J. D. (1995). The incidence of full thickness rotator cuff tears in a large cadaveric population. Bulletin of the Hospital for Joint Diseases, 54, 30–31.

    CAS  Google Scholar 

  • Leroux, J. L., Codine, P., Thomas, E., Pocholle, M., Mailhe, D., & Blotman, F. (1994). Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome. Clinical Orthopaedics, 304, 108–115.

    Google Scholar 

  • Lindblom, K. (1939). On pathogenesis of ruptures of the tendon aponeurosis of the shoulder joint. Acta Radiologica, 20, 563–577.

    Article  Google Scholar 

  • Liotard, J. P., Cochard, P., & Walch, G. (1998). Critical analysis of the supraspinatus outlet view: Rationale for a standard scapular Y-view. Journal of Shoulder and Elbow Surgery, 7, 134–139.

    Article  PubMed  CAS  Google Scholar 

  • Lisy, M., Hreusik, P., & Steno, B. (2004). The shape of the acromion and its effect on the subacromial space. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaka (Praha), 71, 110–114.

    CAS  Google Scholar 

  • Lohr, J. F., & Uhthoff, H. K. (1990). The microvascular pattern of the supraspinatus tendon. Clinical Orthopaedics and Related Research, 254, 35–38.

    PubMed  Google Scholar 

  • Lovell, N. (1990). Skeletal and dental pathology of free-ranging mountain gorillas. American Journal of Physical Anthropology, 81, 399–412.

    Article  PubMed  CAS  Google Scholar 

  • Ludewig, P. M., & Cook, T. M. (2002). Translations of the humerus in persons with shoulder impingement symptoms. Journal of Orthopaedic and Sports Physical Therapy, 32, 248–259.

    PubMed  Google Scholar 

  • MacGillivray, J. D., Fealy, S., Potter, H. G., & O’Brien, S. J. (1998). Multiplanar analysis of acromion morphology. American Journal of Sports Medicine, 26, 836–840.

    PubMed  CAS  Google Scholar 

  • Mayerhofer, M. E., & Breitenseher, M. J. (2004). Impingement syndrome of the shoulder. Radiologe, 44, 569–577.

    Article  PubMed  CAS  Google Scholar 

  • Morrison, D. S., & Bigliani, L. U. (1987). The clinical significance of variations in acromial morphology. Orthopaedic Transactions, 11, 234.

    Google Scholar 

  • Neer, C. S. (1972). Anterior acromioplasty for the chronic impingement syndrome in the shoulder: A preliminary report. Journal of Bone and Joint Surgery, 54, 41–50.

    PubMed  Google Scholar 

  • Nirschl, R. P. (1989). Rotator cuff tendinitis: Basic concepts of pathoetiology. In Instructional Course Lectures, vol. 38 (pp. 439–445). Park Ridge, Illinois: The American Academy of Orthopaedic Surgeons.

  • Ogata, S., & Uhthoff, H. K. (1990). Acromial enthesopathy and rotator cuff tear. A radiologic and histologic postmortem investigation of the coracoacromial arch. Clinical Orthopaedics, 254, 39–48.

    Google Scholar 

  • Poppen, N. K., & Walker, P. S. (1976). Normal and abnormal motion of the shoulder. Journal of Bone and Joint Surgery of America, 58, 195–201.

    CAS  Google Scholar 

  • Prato, N., Peloso, D., Franconeri, A., Tegaldo, G., Ravera, G. B., Silvestri, E., et al. (1998). The anterior tilt of the acromion: Radiographic evaluation and correlation with shoulder diseases. European Journal of Radiology, 8, 1639–1646.

    Article  CAS  Google Scholar 

  • Prescher, A. (2000). Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle. European Journal of Radiology, 35, 88–102.

    Article  PubMed  CAS  Google Scholar 

  • Putz, R., Liebermann, J., & Reichelt, A. (1988). Funktion des Ligamentum coraco-acromiale. Acta Anatomica, 131, 140–145.

    Article  PubMed  CAS  Google Scholar 

  • Rathburn, J. B., & Macnab, I. (1970). The microvascular pattern of the rotator cuff. Journal of Bone and Joint Surgery, 52, 540–553.

    Google Scholar 

  • Reddy, A. S., Mohr, K. J., Pink, M. M., & Jobe, F. W. (2000). Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement. Journal of Shoulder and Elbow Surgery, 9, 519–523.

    Article  PubMed  CAS  Google Scholar 

  • Roberts, D. (1974). Structure and function of the primate scapula. In F. A. Jenkins (Ed.), Primate locomotion (171–200). New York: Academic Press.

    Google Scholar 

  • Seok-Beom, L., Eiji, I., Shawn, W., & Kai-nan, A. (2001). Contact geometry at the undersurface of the acromion with and without a rotator cuff tear. Arthroscopy, 17, 365–372.

    Google Scholar 

  • Tasu, J. P., Miquel, A., Rocher, L., Molina, V., Gagey, O., & Blery, M. (2001). MR evaluation of factors predicting the development of rotator cuff tears. Journal of Computer Assisted Tomography, 25, 159–163.

    Article  PubMed  CAS  Google Scholar 

  • Thompson, W. O., Debski, R. E., Boardman, N. D., Taskiran, E., Warner, J. J., and Fu, F. H. (1996). A biomechanical analysis of rotator cuff deficiency in a cadaveric model. American Journal of Sports Medicine, 24, 286–292.

    Article  PubMed  CAS  Google Scholar 

  • Toivonen, D. A., Tuite, M. J., & Orwin, J. F. (1995). Acromial structure and tears of the rotator cuff. Journal of Shoulder and Elbow Surgery, 4, 376–383.

    Article  PubMed  CAS  Google Scholar 

  • Tuttle, R. H., & Basmajian, J. V. (1978). Electromyography of pongid shoulder muscles. Part II, deltoid, rhomboid, and “rotator cuff.” American Journal of Physical Anthropology, 49, 47–56.

    Article  PubMed  CAS  Google Scholar 

  • Van der Windt, D. A., Koes, B. W., de Jong, B. A., & Bouter, L. M. (1995). Shoulder disorders in general practice: Incidence, patient characteristics, and management. Annals of the Rheumatic Diseases, 54, 959–964.

    PubMed  Google Scholar 

  • Vaz, S., Soyer, J., Pries, P., & Clarac, J. P. (2000). Subacromial impingement: Influence of coracoacromial arch geometry on shoulder function. Joint Bone Spine, 67, 305–309.

    PubMed  CAS  Google Scholar 

  • Wang, J. C., Horner, G., Brown, E. D., & Shapiro, M. S. (2000). The relationship between acromial morphology and conservative treatment of patients with impingement syndrome. Orthopedics, 23, 557–559.

    PubMed  CAS  Google Scholar 

  • Warner, J. J., Micheli, L. J., Arslanian, L. E., Kennedy, J., & Kennedy, R. (1990). Patterns of flexibility, laxity and strength in normal shoulders and shoulders with instability and impingement. American Journal of Sports Medicine, 18, 366–375.

    Article  PubMed  CAS  Google Scholar 

  • Wickiewicz, T. L. (1994). Glenohumeral kinematics in a muscle fatigue model: A radiographic study. Orthopaedic Transactions, 18, 178–179.

    Google Scholar 

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Acknowledgments

We thank Dr. Juan Francisco Pastor (Department of Human Anatomy and Embryology, University of Valladolid), Dr. Eulalia García (Natural Science Museum of Barcelona), and Dr. Salvador Moyà-Solà and Ms. Teresa Esquirol (Palaeontology Museum Miquel Crusafont, Sabadell) for their contribution to the preparation of this study. We also thank Drs. Alberto Prats-Galino and Anna Puigdellívol (Department of Human Anatomy and Embryology, University of Barcelona), Mr. Manuel Barba, and Mr. Sebastián Mateo (Service of Corpse Donation and Dissecting Room, University of Barcelona) and Ms. Carme Sanahuges (Gimbernat Physical Therapy School, Sant Cugat del Vallès) for their support and collaboration.

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  1. Comparative and Evolutionary Anatomy Unit, Department of Human Anatomy and Embryology, School of Medicine, University of Barcelona, 08036, Barcelona, Spain

    J. M. Potau & N. Ciurana

  2. Gimbernat School of Physical Therapy, Avinguda de la Generalitat, 08174, Sant Cugat del Vallès, Spain

    X. Bardina

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  1. J. M. Potau
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Correspondence to J. M. Potau.

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Potau, J.M., Bardina, X. & Ciurana, N. Subacromial Space in African Great Apes and Subacromial Impingement Syndrome in Humans. Int J Primatol 28, 865–880 (2007). https://doi.org/10.1007/s10764-007-9167-z

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