Schmidt, J Bone Joint Surg Am 2022 - The Rotator Cable Does Not Stress Shield the Crescent Area during Shoulder Abduction

The Rotator Cable Does Not Stress Shield the Crescent Area during Shoulder Abduction

Schmidt, Smolinski, et al.·J Bone Joint Surg Am·2022

Background

It is accepted by the orthopaedic community that the rotator cable (RCa) acts as a suspension bridge that stress shields the crescent area (CA). The goal of this study was to determine if the RCa does stress shield the CA during shoulder abduction.

Methods

The principal strain magnitude and direction in the RCa and CA and shoulder abduction force were measured in 20 cadaveric specimens.
10 specimens underwent a release of the anterior cable insertion followed by a posterior release.
In the other 10, a release of the posterior cable insertion was followed by an anterior release.
Testing was performed for the native, single-release, and full-release conditions.
The thicknesses of the RCa and CA were measured.

Results

Neither the principal strain magnitude nor the strain direction in either the RCa or the CA changed with single or full RCa release (p ≥ 0.493).
There were no changes in abduction force after single or full RCa release (p ≥ 0.180).
The RCa and CA thicknesses did not differ from one another at any location (p ≥ 0.195).

Conclusions

The RCa does not act as a suspension bridge and does not stress shield the CA. The CA primarily transfers shoulder abduction force to the greater tuberosity.

Clinical Relevance: The CA is important in force transmission during shoulder abduction, and efforts should be made to restore its continuity with a repair or reconstruction.

Core

The Rotator Cable Does Not Stress Shield the Crescent Area during Shoulder Abduction.

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The Rotator Cable Does Not Stress Shield the Crescent Area during Shoulder Abduction

Schmidt, Smolinski, et al.·J Bone Joint Surg Am·2022

DOI·PubMed

Background

Methods

The principal strain magnitude and direction in the RCa and CA and shoulder abduction force were measured in 20 cadaveric specimens.
10 specimens underwent a release of the anterior cable insertion followed by a posterior release.
In the other 10, a release of the posterior cable insertion was followed by an anterior release.
Testing was performed for the native, single-release, and full-release conditions.
The thicknesses of the RCa and CA were measured.

Results

Neither the principal strain magnitude nor the strain direction in either the RCa or the CA changed with single or full RCa release (p ≥ 0.493).
There were no changes in abduction force after single or full RCa release (p ≥ 0.180).
The RCa and CA thicknesses did not differ from one another at any location (p ≥ 0.195).

Conclusions

The RCa does not act as a suspension bridge and does not stress shield the CA. The CA primarily transfers shoulder abduction force to the greater tuberosity.

Clinical Relevance: The CA is important in force transmission during shoulder abduction, and efforts should be made to restore its continuity with a repair or reconstruction.

Background

Methods

The principal strain magnitude and direction in the RCa and CA and shoulder abduction force were measured in 20 cadaveric specimens.
10 specimens underwent a release of the anterior cable insertion followed by a posterior release.
In the other 10, a release of the posterior cable insertion was followed by an anterior release.
Testing was performed for the native, single-release, and full-release conditions.
The thicknesses of the RCa and CA were measured.

Results

Neither the principal strain magnitude nor the strain direction in either the RCa or the CA changed with single or full RCa release (p ≥ 0.493).
There were no changes in abduction force after single or full RCa release (p ≥ 0.180).
The RCa and CA thicknesses did not differ from one another at any location (p ≥ 0.195).

Conclusions

The RCa does not act as a suspension bridge and does not stress shield the CA. The CA primarily transfers shoulder abduction force to the greater tuberosity.

Clinical Relevance: The CA is important in force transmission during shoulder abduction, and efforts should be made to restore its continuity with a repair or reconstruction.

Background

Methods

The principal strain magnitude and direction in the RCa and CA and shoulder abduction force were measured in 20 cadaveric specimens.
10 specimens underwent a release of the anterior cable insertion followed by a posterior release.
In the other 10, a release of the posterior cable insertion was followed by an anterior release.
Testing was performed for the native, single-release, and full-release conditions.
The thicknesses of the RCa and CA were measured.

Results

Neither the principal strain magnitude nor the strain direction in either the RCa or the CA changed with single or full RCa release (p ≥ 0.493).
There were no changes in abduction force after single or full RCa release (p ≥ 0.180).
The RCa and CA thicknesses did not differ from one another at any location (p ≥ 0.195).

Conclusions

The RCa does not act as a suspension bridge and does not stress shield the CA. The CA primarily transfers shoulder abduction force to the greater tuberosity.

Clinical Relevance: The CA is important in force transmission during shoulder abduction, and efforts should be made to restore its continuity with a repair or reconstruction.