Shoulder labral pathomechanics with rotator cuff tears. 2014

Eunjoo Hwang, and James E Carpenter, and Richard E Hughes, and Mark L Palmer
School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.

Rotator cuff tears (RCTs), the most common injury of the shoulder, are often accompanied by tears in the superior glenoid labrum. We evaluated whether superior humeral head (HH) motion secondary to RCTs and loading of the long head of the biceps tendon (LHBT) are implicated in the development of this associated superior labral pathology. Additionally, we determined the efficacy of a finite element model (FEM) for predicting the mechanics of the labrum. The HH was oriented at 30° of glenohumeral abduction and neutral rotation with 50N compressive force. Loads of 0N or 22N were applied to the LHBT. The HH was translated superiorly by 5mm to simulate superior instability caused by RCTs. Superior displacement of the labrum was affected by translation of the HH (P<0.0001), position along the labrum (P<0.0001), and interaction between the location on the labrum and LHBT tension (P<0.05). The displacements predicted by the FEM were compared with mechanical tests from 6 cadaveric specimens and all were within 1 SD of the mean. A hyperelastic constitutive law for the labrum was a better predictor of labral behavior than the elastic law and insensitive to ±1 SD variations in material properties. Peak strains were observed at the glenoid-labrum interface below the LHBT attachment consistent with the common location of labral pathology. These results suggest that pathomechanics of the shoulder secondary to RCTs (e.g., superior HH translation) and LHBT loading play significant roles in the pathologic changes seen in the superior labrum.

UI MeSH Term Description Entries
D008297 Male Males
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070599 Shoulder Injuries Injuries involving the SHOULDERS and SHOULDER JOINT. SLAP Tears,Superior Labrum from Anterior to Posterior Injuries,Injuries, Shoulder,Injury, Shoulder,SLAP Tear,Shoulder Injury,Tear, SLAP,Tears, SLAP
D000070636 Rotator Cuff Injuries Injuries to the ROTATOR CUFF of the shoulder joint. Glenoid Labral Tears,Rotator Cuff Tears,Rotator Cuff Tendinitis,Rotator Cuff Tendinosis,Cuff Injury, Rotator,Glenoid Labral Tear,Injury, Rotator Cuff,Labral Tear, Glenoid,Labral Tears, Glenoid,Rotator Cuff Injury,Rotator Cuff Tear,Rotator Cuff Tendinitides,Rotator Cuff Tendinoses,Tear, Glenoid Labral,Tear, Rotator Cuff,Tears, Rotator Cuff,Tendinitis, Rotator Cuff,Tendinoses, Rotator Cuff,Tendinosis, Rotator Cuff
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012399 Rotation Motion of an object in which either one or more points on a line are fixed. It is also the motion of a particle about a fixed point. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Clinorotation,Clinorotations,Rotations
D012785 Shoulder Joint The articulation between the head of the HUMERUS and the glenoid cavity of the SCAPULA. Glenohumeral Joint,Glenoid Labrum,Glenohumeral Joints,Joint, Glenohumeral,Joint, Shoulder,Joints, Glenohumeral,Joints, Shoulder,Labrum, Glenoid,Shoulder Joints
D017006 Rotator Cuff The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the HUMERAL HEAD in the GLENOID CAVITY of the SCAPULA and allow for rotation of the SHOULDER JOINT about its longitudinal axis. Cuff, Rotator,Infraspinatus,Subscapularis,Supraspinatus,Teres Minor,Rotator Cuffs
D058430 Humeral Head The upper rounded extremity of the humerus fitting into the GLENOID CAVITY of the SCAPULA. Humerus Head,Humeral Heads,Humerus Heads

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