title: Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading.
abstract: The passive properties of the rotator cuff have been shown to provide some stability during anterior-posterior (AP) translation. However, the relative importance of the rotator cuff to joint stability remains unclear. The purpose of this study was to quantify the force contributions of the rotator cuff and of capsuloligamentous structures at the glenohumeral joint during AP loading. We hypothesized that the rotator cuff acts as a significant passive stabilizer of the glenohumeral joint and that its contribution to joint stability is comparable to the contribution made by the components of the glenohumeral capsule. A robotic/universal force-moment sensor testing system was used to determine both the multiple "degrees of freedom" joint motion and the in situ force carried by each soft tissue structure during application of an 89N AP load at 4 abduction angles. The percent contribution of the rotator cuff to the resisting force of the intact joint during AP loading was significantly greater during posterior loading (35% +/- 26%) than during anterior loading at 60 degrees of abduction (P < .05). The contribution of the rotator cuff (i.e., 29% +/- 16% at 30 degrees of abduction) was found to be significantly greater than the contributions of the capsule components during posterior loading at 30 degrees, 60 degrees, and 90 degrees of abduction (P < .05). However, no differences could be found between the respective contributions of the rotator cuff and the capsule components during anterior loading. The results support our hypothesis and suggest that passive tension in the rotator cuff plays a more significant role than other soft tissue structures in resisting posterior loads at the glenohumeral joint. The important role of the rotator cuff during posterior loading may be a result of the thin posterior joint capsule compared with the anterior capsule, which has several thickenings. This information increases our understanding of posterior stability at the glenohumeral joint during clinical laxity tests.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, PA 15213, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Debski
authors.forename: M
authors.initials: M
authors.lastname: Sakone
authors.forename: S L
authors.initials: SL
authors.lastname: Woo
authors.forename: E K
authors.initials: EK
authors.lastname: Wong
authors.forename: F H
authors.initials: FH
authors.lastname: Fu
authors.forename: J J
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D066298:In Vitro Techniques; D008023:Ligaments, Articular / Q000502:physiology; D009068:Movement; D017006:Rotator Cuff / Q000502:physiology*; D012785:Shoulder Joint / Q000502:physiology*; D013314:Stress, Mechanical