Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleStress Distribution in Superior Labral Complex and Rotator Cuff During In Vivo Shoulder Motion: A Finite Element Analysis
Section snippets
3D Bone Modeling and Motion Simulation Procedure
The right shoulder of a 29-year-old volunteer was scanned with a high-resolution CT scanner (Somatom Sensation; Siemens, Erlangen, Germany) with 1-mm slices taken at 2 different shoulder angles in the prone position: 0° (neutral rotation) and the ABER position. The prone position was selected because it was believed to allow appropriate scapular motion while positioning the shoulder at different abduction angles in limited space. The study was approved by our institutional review board
Results
In the ABER position, the posterosuperior labrum was deformed by the humeral head and interposed posterior part of the rotator cuff. When viewed from the rotator cuff, the posterior part of the rotator cuff came into contact with the posterosuperior labrum as external rotation increased, as depicted in Figure 4. In the designed SLAP model, the posterosuperior labrum moved medially rather than undergoing structural deformation during ABER movement.
The peak contact stress values at the ABER
Discussion
The principal findings of this study determined that the posterior part of the upper rotator cuff, LHB, and posterosuperior labrum were the structures at risk with the ABER position. These findings suggest that those structures might be damaged by repetitive impingement when the arm is in an abducted and maximally externally rotated position.14, 15, 25
High stresses especially on the undersurface of the posterior rotator cuff and posterosuperior labrum were caused by mutual compression between
Conclusions
In this simulated SLAP model, the posterosuperior labrum was medially displaced by the humeral head and upper rotator cuff in the ABER position, causing a functional loss of the spacer effect.
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The authors report the following potential conflict of interest or source of funding: Funded by the National Research Foundation of Korea, Ministry of Education (grant 2013R1A1A2011589 to Y-S.Y.).