Elsevier

Journal of Shoulder and Elbow Surgery

Volume 12, Issue 6, November–December 2003, Pages 612-617
Journal of Shoulder and Elbow Surgery

Original article
Mechanical environment of the supraspinatus tendon: a two-dimensional finite element model analysis

https://doi.org/10.1016/S1058-2746(03)00214-3Get rights and content

Abstract

We performed 2-dimensional finite element model analysis to estimate the mechanical environment of the supraspinatus tendon. The geometric shape of the finite element model was determined by magnetic resonance imaging of a normal human shoulder obtained at 0°, 30°, and 60° of abduction, whereas the histologic location of noncalcified and calcified fibrocartilage was determined from a cadaveric specimen. The supraspinatus tendon was pulled proximally with the force of 10 N at 0°, 53 N at 30°, and 115 N at 60° of abduction. The area of high principal stress maximum was observed on the articular side of the supraspinatus tendon, which shifted toward the insertion as the arm was abducted. High stress concentration on the articular side of the supraspinatus tendon near its insertion during arm elevation may explain the frequent occurrence of rotator cuff tears at this site.

Section snippets

Materials and methods

Two-dimensional finite element model analysis was performed with the software programs MENTAT (version 3.2.0; MSC Software Corporation, Tokyo, Japan) and MARC (version 3.3.0; MSC Software Corporation). The geometric shape and anatomic relationship of the supraspinatus tendon and the humeral head were determined from MR images of a right shoulder in a healthy 28-year-old woman (Figure 1). The glenohumeral joint was abducted to 0°, 30°, and 60° in the scapular plane with the subject in the

Results

The contact area between the supraspinatus tendon and the humeral head decreased as the arm was abducted, and there was no contact between them at 60° of abduction. The tensile stress and compressive stress are shown in Figure 6, Figure 7. At 0° of abduction, the tensile stress area was observed on the articular side of the supraspinatus tendon contacting the top of the humeral head, where the tensile load was tangential to the humeral head. It shifted closer to the tendon insertion as the

Strength of our model

A finite element model of the supraspinatus tendon was first reported by Luo et al.11 The geometric shape of their model was determined based on MR images obtained from a fresh cadaveric shoulder. However, they did not take the attachment structure of the tendon as well as the bony structures into consideration. In general, tendon insertion into the bone is composed of 4 zones: tendon proper, noncalcified fibrocartilage, calcified fibrocartilage, and bone. These specific structures may have

Acknowledgements

We thank Prof Hans K Uhthoff, Eiji Takaoki, Mamoru Takahashi, and Koumei Narita for their assistance.

References (21)

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    Citation Excerpt :

    Additionally, a model comprising both interfaces (i.e. UFC/MFC and MFC/bone), with their specific morphologies, is still missing but could be helpful to better target the weakness of reattachment procedures, which fail to reproduce such complex interfacial shapes. The number of orthopedic injuries requiring the reattachment of tendons or ligaments to bone, together with the complexity of the surgical procedure and the poor long-term clinical outcome (Lu and Thomopoulos, 2013; Galatz et al., 2004), have triggered the development of computational models at the macroscopic length scale (Thomopoulos et al., 2006; Inoue et al., 2013; Wakabayashi et al., 2003; Funakoshi et al., 2008; Sano et al., 2006b; Quental et al., 2016; Mantovani et al., 2016; Liu et al., 2012). These models differ from the approaches presented in the previous sections as they essentially try to investigate the mechanical behavior of the whole bone-soft tissue complex as well as to answer specific orthopedic-related questions.

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