Annals of Biomedical Engineering

, Volume 30, Issue 8, pp 1057–1063 | Cite as

Rotator Cuff Tendinosis in an Animal Model: Role of Extrinsic and Overuse Factors

  • Louis J. Soslowsky
  • Stavros Thomopoulos
  • Adil Esmail
  • Colleen L. Flanagan
  • Joseph P. Iannotti
  • J. David WilliamsonIII
  • James E. Carpenter


The rat shoulder animal model has been used previously to study the role of intrinsic injury (modeled as an acute insult to the tendon), extrinsic injury (modeled as external subacromial impingement), and overuse factors on rotator cuff tendinosis. These studies demonstrated that it is possible to produce rotator cuff tendinosis with any one of these factors in isolation. The current study uses the rat shoulder model to study the roles of extrinsic compression, overuse, and overuse in combination with extrinsic compression, on the development of rotator cuff tendinosis. The results of this study demonstrate that the injury created by overuse plus extrinsic compression is greater than the injuries created by overuse or extrinsic compression alone, particularly when important biomechanical variables are considered. While ineffective in causing a change in supraspinatus tendon properties in animals with normal cage activity, extrinsic compression had a significant and dramatic effect when it was combined with overuse activity. Without an additional factor, such as overhead activity, the extrinsic compression alone may be insufficient to cause tendinosis. The results of the present study support the role of multiple factors in the etiology of some rotator cuff injuries. © 2002 Biomedical Engineering Society.

PAC2002: 8719Rr, 8719St

Shoulder Mechanical properties Tendon Supraspinatus Tendonitis Tendonosis Rotator cuff Impingement Overuse 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bigliani, L. U., J. B. Ticker, E. L. Flatow, L. J. Soslowsky, and V. C. Mow. Relationship of acromial architecture to rotator cuff disease. Clin. Sports Med. 10:823-838, 1991.Google Scholar
  2. 2.
    Bureau of Labor Statistics, Occupational Injuries and Illnesses in the United States by Industry, 1988. Bulletin No. 2368, August 1990.Google Scholar
  3. 3.
    Carpenter, J. E., C. L. Flanagan, S. Thomopoulos, E. H. Yian, and L. J. Soslowsky. The effects of overuse combined with intrinsic or extrinsic alterations in an animal model of rotator cuff tendinosis. Am. J. Sports Med. 26:801-807, 1998.Google Scholar
  4. 4.
    Carpenter, J. E., S. Thomopoulos, C. L. Flanagan, C. M. DeBano, and L. J. Soslowsky. Rotator cuff defect healing. A biomechanical and histological analysis in an animal model. J. Shoulder Elbow Surg. 7:599-605, 1998.Google Scholar
  5. 5.
    Codman, E. A., and I. B. Akerson.The pathology associated with rupture of the supraspinatus tendon. Ann. Surg. 93:348-359, 1931.Google Scholar
  6. 6.
    Jobe, F. W., R. S. Kvitne, and C. E. Giangarra. Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement in [published erratum in Orthop. Rev. 8:1268, 1989] Orthop. Rev. 18:963-975, 1989.Google Scholar
  7. 7.
    Leadbetter, W. C. Cell-matrix response in tendon injury. Clin. Sports Med. 11:533-578, 1992.Google Scholar
  8. 8.
    Lohr, J. F., and H. K. Uhthoff. The microvascular pattern of the supraspinatus tendon. Clin. Orthop. Relat. Res. 254:35-38, 1990.Google Scholar
  9. 9.
    McMaster, W., and J. Troup. A survey of interfering shoulder pain in United States competitive swimmers. Am. J. Sports Med. 21:67-70, 1993.Google Scholar
  10. 10.
    Meyer, A. W. The minute anatomy of attrition lesions. J. Bone Jt. Surg. 13:341-360, 1931.Google Scholar
  11. 11.
    Moseley, H. F., and I. Goldie. The arterial pattern of the rotator cuff of the shoulder. J. Bone Jt. Surg. 45B:780-789, 1963.Google Scholar
  12. 12.
    Neer, C. S. Shoulder Reconstruction. Philadelphia: Saunders, 1994, 624 pp.Google Scholar
  13. 13.
    Ozaki, J., S. Fujimoto, Y. Nakagawa, K. Masuhara, and S. Tamai. Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. J. Bone Jt. Surg. 70A:1224-1230, 1988.Google Scholar
  14. 14.
    Rathbun, J. B., and I. Macnab. The microvascular pattern of the rotator cuff. J. Bone Jt. Surg. 52B:540-553, 1970.Google Scholar
  15. 15.
    Renstrom, P., and R. J. Johnston. Overuse injuries in sports: A review. Sports Med. 2:316-333, 1985.Google Scholar
  16. 16.
    Sommer, H. M. The biomechanical and metabolic effects of a running regime on the Achilles tendon in the rat. Int. Orthop. 11:71-75, 1987.Google Scholar
  17. 17.
    Soslowsky, L. J., C. H. An, C. M. DeBano, and J. E. Carpenter. The coracoacromial ligament: In situ load and viscoelastic properties in rotator cuff disease. Clin. Orthop. Relat. Res. 330:40-44, 1996.Google Scholar
  18. 18.
    Soslowsky, L. J., J. E. Carpenter, C. M. DeBano, I. Banerji, and M. R. Moalli. Development and use of an animal model for investigations on rotator cuff disease. J. Shoulder Elbow Surg. 5:383-392, 1996.Google Scholar
  19. 19.
    Soslowsky, L. J., S. Thomopoulos, S. Tun, C. L. Flanagan, C. C. Keefer, J. Mastaw, and J. E. Carpenter. Overuse activity injures the supraspinatus tendon in an animal model: Histologic and biomechanical study. J. Shoulder Elbow Surg. 9:79-84, 2000.Google Scholar
  20. 20.
    Uhthoff, H. K., and K. Sarkar. Classification and definition of tendinopathies. Clin. Sports Med. 10:707-720, 1991.Google Scholar
  21. 21.
    Uhthoff, H. K., and H. Sano. Pathology of failure of the rotator cuff tendon. Orthop. Clin. North Am. 28:31-41, 1997.Google Scholar
  22. 22.
    Yeh, J. K., J. F. Aloia, J. M. Tierney, and S. Sprintz. Effect of treadmill exercise on vertebral and tibial bone mineral content and bone mineral density in the aged adult rat: Determined by dual-energy x-ray absorptiometry. Calcif. Tissue Int. 52:234-238, 1993.Google Scholar
  23. 23.
    Zuckerman, J. D., F. J. Kummer, F. Cuomo, J. Simon, S. Rosenblum, and N. Katz. Influence of coracoacromial arch anatomy on rotator cuff tears. J. Shoulder Elbow Surg. 1:4-14, 1992.Google Scholar

Copyright information

© Biomedical Engineering Society 2002

Authors and Affiliations

  • Louis J. Soslowsky
    • 1
  • Stavros Thomopoulos
    • 1
  • Adil Esmail
    • 1
  • Colleen L. Flanagan
    • 1
  • Joseph P. Iannotti
    • 1
  • J. David WilliamsonIII
    • 1
  • James E. Carpenter
    • 2
  1. 1.McKay Orthopaedic Research LaboratoryUniversity of PennsylvaniaPhiladelphia
  2. 2.Orthopaedic Research LaboratoriesUniversity of MichiganAnn Arbor

Personalised recommendations