title: Rotator cuff tendon connections with the rotator cable.
abstract: OBJECTIVE
  The literature currently contains no descriptions of the rotator cuff tendons, which also describes in relation to the presence and characteristics of the rotator cable (anatomically known as the ligamentum semicirculare humeri). The aim of the current study was to elucidate the detailed anatomy of the rotator cuff tendons in association with the rotator cable.
  
  
  METHODS
  Anatomic dissection was performed on 21 fresh-frozen shoulder specimens with an average age of 68 years. The rotator cuff tendons were dissected from each other and from the glenohumeral joint capsule, and the superior glenohumeral, coracohumeral, coracoglenoidal and semicircular (rotator cable) ligaments were dissected. Dissection was performed layer by layer and from the bursal side to the joint. All ligaments and tendons were dissected in fine detail.
  
  
  RESULTS
  The rotator cable was found in all specimens. It was tightly connected to the supraspinatus (SSP) tendon, which was partly covered by the infraspinatus (ISP) tendon. The posterior insertion area of the rotator cable was located in the region between the middle and inferior facets of the greater tubercle of the humerus insertion areas for the teres minor (TM), and ISP tendons were also present and fibres from the SSP extended through the rotator cable to those areas.
  
  
  CONCLUSIONS
  The connection between the rotator cable and rotator cuff tendons is tight and confirms the suspension bridge theory for rotator cuff tears in most areas between the SSP tendons and rotator cable. In its posterior insertion area, the rotator cable is a connecting structure between the TM, ISP and SSP tendons. These findings might explain why some patients with relatively large rotator cuff tears can maintain seamless shoulder function.
authors.affiliation: Institute of Anatomy, University of Tartu, Ravila 19, 50411, Tartu, Estonia. madis.rahu@regionaalhaigla.ee.|Department of Orthopedics, North Estonia Medical Centre, J. Sütiste tee 19, 13419, Tallinn, Estonia. madis.rahu@regionaalhaigla.ee.
authors.forename: Madis
authors.initials: M
authors.lastname: Rahu
authors.affiliation: Institute of Anatomy, University of Tartu, Ravila 19, 50411, Tartu, Estonia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Kolts
authors.affiliation: Institute of Anatomy, University of Tartu, Ravila 19, 50411, Tartu, Estonia.
authors.forename: Elle
authors.initials: E
authors.lastname: Põldoja
authors.affiliation: Department of Orthopedics, North Estonia Medical Centre, J. Sütiste tee 19, 13419, Tallinn, Estonia.
authors.forename: Kristo
authors.initials: K
authors.lastname: Kask
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004210:Dissection; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000033:anatomy & histology*
keywords: Anatomy; Ligamentum semicirculare humeri; Rotator cable; Rotator cuff muscle tendons