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Biomechanical analysis of the humeral head coverage, glenoid inclination and acromio-glenoidal height as isolated components of the critical shoulder angle in a dynamic cadaveric shoulder model


Bouaicha, Samy; Kuster, Roman Peter; Schmid, Bruno; Baumgartner, Daniel; Zumstein, Matthias; Moor, Beat Kaspar (2019). Biomechanical analysis of the humeral head coverage, glenoid inclination and acromio-glenoidal height as isolated components of the critical shoulder angle in a dynamic cadaveric shoulder model. Clinical Biomechanics, 72:115-121.

Abstract

BACKGROUND

The Critical Shoulder Angle was introduced as a combined radiographic surrogate parameter reflecting the influence of the morphological characteristics of the scapula on the development of degenerative shoulder disease such as rotator cuff tears and osteoarthritis. Although, glenoid inclination and lateral extension of the acromion were studied in biomechanical models separately, no investigation included all three individual parameters that determine the Critical Shoulder Angle: glenoid inclination, acromial coverage and acromial height in one cadaveric study protocol.

METHODS

Three proximal humerus cadavers were attached to a robotic shoulder simulator which allowed for independent change of either lateral acromial coverage, glenoid inclination or acromial height. Combined dynamic scapula-thoracic and glenohumeral abduction up to 60° with different Critical Shoulder Angle configurations was performed and muscle forces as well as joint reaction forces were recorded.

FINDINGS

All three components had an effect on either muscle forces and or joint reaction forces. While glenoid inclination showed the highest impact on joint stability with increasing upward-tilting causing cranial subluxation, changing of the lateral acromial coverage or acromial height had less influence on stability but showed significant alteration of joint reaction forces.

INTERPRETATION

All three components of the Critical Shoulder Angle, glenoid inclination, lateral acromial extension and acromial height showed independent biomechanical effects when changed isolated. However, glenoid inclination seems to have the largest impact regarding joint stability.

Abstract

BACKGROUND

The Critical Shoulder Angle was introduced as a combined radiographic surrogate parameter reflecting the influence of the morphological characteristics of the scapula on the development of degenerative shoulder disease such as rotator cuff tears and osteoarthritis. Although, glenoid inclination and lateral extension of the acromion were studied in biomechanical models separately, no investigation included all three individual parameters that determine the Critical Shoulder Angle: glenoid inclination, acromial coverage and acromial height in one cadaveric study protocol.

METHODS

Three proximal humerus cadavers were attached to a robotic shoulder simulator which allowed for independent change of either lateral acromial coverage, glenoid inclination or acromial height. Combined dynamic scapula-thoracic and glenohumeral abduction up to 60° with different Critical Shoulder Angle configurations was performed and muscle forces as well as joint reaction forces were recorded.

FINDINGS

All three components had an effect on either muscle forces and or joint reaction forces. While glenoid inclination showed the highest impact on joint stability with increasing upward-tilting causing cranial subluxation, changing of the lateral acromial coverage or acromial height had less influence on stability but showed significant alteration of joint reaction forces.

INTERPRETATION

All three components of the Critical Shoulder Angle, glenoid inclination, lateral acromial extension and acromial height showed independent biomechanical effects when changed isolated. However, glenoid inclination seems to have the largest impact regarding joint stability.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Biophysics
Health Sciences > Orthopedics and Sports Medicine
Language:English
Date:6 December 2019
Deposited On:12 Feb 2020 10:51
Last Modified:29 Jul 2020 13:26
Publisher:Elsevier
ISSN:0268-0033
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.clinbiomech.2019.12.003
PubMed ID:31862605

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