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The effect of scapular position on subacromial contact behavior a cadaver study.pdf

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The effect of scapular position on subacromial contact behavior a cadaver study.pdf

ARTICLE IN PRESS J Shoulder Elbow Surg (2017) ■■, ■■–■■ /locate/ymse ORIGINAL ARTICLE The effect of scapular position on subacromial contact behavior: a cadaver study Takayuki Muraki, PT, PhDa, Nobuyuki Yamamoto, MD, PhDa, John W. Sperling, MD, MBAb, Scott P. Steinmann, MDb, Robert H. Cofield, MDb, Kai-Nan An, PhDb,* aBiomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA bDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Background: Patients with subacromial impingement were reported to show abnormal scapular positions during shoulder elevation. However, the relationship between the scapular positions and subacromial impingement is unclear. The purpose of this study was to biomechanically determine the effect of scapular position on subacromial contact behavior by using fresh frozen cadavers. Methods: The peak contact pressure on the coracoacromial arch was measured with a ?exible tactile force sensor in 9 fresh frozen cadaver shoulders. The measurement was performed during passive glenohumeral elevation in the scapular plane ranging from 30° to 75°. The scapular downward and internal rotations and anterior tilt were simulated by tilting the scapula in 5° increments up to 20°. The measurement was also performed with combination of scapular downward and internal rotations and anterior tilt positions. Results: The peak contact pressure decreased linearly with anterior tilt, and a signi?cant difference between neutral scapular position (1.06 ± 0.89 MPa) and anterior tilt by 20° (0.46 ± 0.18 MPa) was observed (P .05). However, the scapular positioning in the other directions did not change the peak contact pressure signi?cantly. Furthermore, any combination of abnormal scapular positions did not affect peak contact pressure signi?cantly. Conclusion: Scapular anterior tilt decreased peak contact pressure during passive shoulder elevation. In addition, scapular downward and internal rotations had little effect on peak c