Araştırma Makalesi
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The Relationship Between Supraspinatus Tendon Moment Arm Length, Shoulder Anatomical Features, and Shoulder Disorders

Yıl 2025, Cilt: 51 Sayı: 2, 271 - 275, 28.08.2025
https://doi.org/10.32708/uutfd.1621854

Öz

This study aimed to evaluate the relationship between the moment arm length of the supraspinatus tendon and shoulder pathologies. The muscle-tendon moment arm represents the mechanical advantage of a muscle and significantly influences its role as a stabilizer or prime mover. In 83 patients, the presence of biceps tendinitis, rotator cuff tendinosis and tears, acromioclavicular joint degeneration, and footprint cysts were assessed. A perpendicular line was drawn from the center of the humeral head to the center of joint motion, and its length was measured (B). The distance from the rotator cuff footprint to the center of joint motion was also calculated (A). Subsequently, the ratio of these two lengths was determined (A/B). The mean moment arm length ratio (A/B) was 1.53 ± 0.11, the mean subacromial distance was 8.56 ± 1.35 mm, and the mean coracohumeral distance was 8.51 ± 1.51 mm. No significant correlation was identified between moment arm length and shoulder pathologies that could impact diagnosis, characterization, or treatment planning. A reduction in coracohumeral distance was associated with an increased incidence of tendinosis and tears in the subscapular tendon. Similarly, a decrease in subacromial distance correlated with a higher incidence of rotator cuff tears. Although moment arm length is important in surgical planning following tendon rupture, it does not serve as a diagnostic guide. The association between subacromial and coracohumeral distances and rotator cuff tendon tears may reflect a bidirectional relationship, where anatomical narrowing and tendon injury may influence each other.

Etik Beyan

Ethical approval for the study was obtained from the Clinical Research Ethics Committee of Mersin University (approval number: 2023/729, dated 01.11.2023) prior to its initiation.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • 1. van der Heijden GJ. Shoulder disorders: a state-of-the-art review. Best Practice & Research Clinical Rheumatology.1999;13(2):287-309.
  • 2. Roy J-S, Braën C, Leblond J, et al. Diagnostic accuracy ofultrasonography, MRI and MR arthrography in thecharacterisation of rotator cuff disorders: a systematic reviewand meta-analysis. British journal of sports medicine.2015;49(20):1316-1328.
  • 3. Juul-Kristensen B, Bojsen-Møller F, Finsen L, et al. Musclesizes and moment arms of rotator cuff muscles determined bymagnetic resonance imaging. Cells Tissues Organs.2000;167(2-3):214-222.
  • 4. Maganaris CN. Imaging-based estimates of moment arm lengthin intact human muscle-tendons. European journal of appliedphysiology. 2004;91:130-139.
  • 5. Ackland DC, Pak P, Richardson M, et al. Moment arms of themuscles crossing the anatomical shoulder. Journal of anatomy.2008;213(4):383-390.
  • 6. Pandy MG. 4 Moment A rm of a Muscle Force. Exercise andsport sciences reviews. 1999;27(1):79-118.
  • 7. Oh JH, Kim JY, Lee HK, et al. Classification and clinicalsignificance of acromial spur in rotator cuff tear: heel-type spurand rotator cuff tear. Clinical Orthopaedics and RelatedResearch®. 2010;468(6):1542-1550.
  • 8. Tan V, Moore Jr RS, Omarini L, et al. Magnetic resonanceimaging analysis of coracoid morphology and its relation torotator cuff tears. American journal of orthopedics (Belle Mead, NJ). 2002;31(6):329-333.
  • 9. Heuberer PR, Plachel F, Willinger L, et al. Critical shoulderangle combined with age predict five shoulder pathologies: aretrospective analysis of 1000 cases. BMC musculoskeletaldisorders. 2017;18:1-9.
  • 10. Lu B. The morphology of the acromion and its relationship torotator cuff tear. Orthop Trans. 1986;10:228.
  • 11. Zhang Y, Herbert RD, Bilston LE, et al. Three‐dimensional architecture and moment arms of human rotator cuff muscles invivo: Interindividual, intermuscular, and intramuscular variations. Journal of Anatomy. 2024.
  • 12. Hughes RE, Niebur G, Liu J, et al. Comparison of two methodsfor computing abduction moment arms of the rotator cuff.Journal of biomechanics. 1997;31(2):157-160.
  • 13. Leschinger T, Birgel S, Hackl M, et al. A musculoskeletalshoulder simulation of moment arms and joint reaction forcesafter medialization of the supraspinatus footprint in rotator cuffrepair. Computer Methods in Biomechanics and BiomedicalEngineering. 2019;22(6):595-604.
  • 14. Wu H, Zuo Z, Li Y, et al. Anatomic characteristics of shoulderbased on MRI accurately predict incomplete rotator cuffinjuries in patients: relevance for predictive, preventive, andpersonalized healthcare strategies. EPMA J 2023:553-570.
  • 15. Yadav SK, Zhu WH. A systematic review: Of acromion typesand its effect on degenerative rotator cuff tear. InternationalJournal of Orthopaedics. 2017;3(1):453-458.
  • 16. Saupe N, Pfirrmann CW, Schmid MR, et al. Associationbetween rotator cuff abnormalities and reducedacromiohumeral distance. American Journal of Roentgenology.2006;187(2):376-382.
  • 17. Goutallier D, Le Guilloux P, Postel J-M, et al. Acromiohumeral distance less than six millimeter: its meaning in full-thickness rotator cuff tear. Orthopaedics & Traumatology:Surgery & Research. 2011;97(3):246-251.
  • 18. Seitz AL, Michener LA. Ultrasonographic measures ofsubacromial space in patients with rotator cuff disease: asystematic review. Journal of clinical ultrasound.2011;39(3):146-154.
  • 19. Çetinkaya M, Kaptan AY, Ulucaköy C, et al. Is it the subcoracoid impingement or the subacromial impingement thattears the subscapularis tendon? A comparison of the MRIfindings of the operated and healthy shoulders of the patients.Turk J Med Sci. 2023;53(1):273-281.
  • 20. Mi Y, Lin Y, Cheng B. Magnetic resonance imaging basedcoracoid process morphology and its associations with isolatedsubscapularis tendon tears in Chinese patients. Jt Dis RelatSurg. 2024;35(2):267-275.

Supraspinatus Tendonunun Moment Kolu Uzunluğu ve Omuz Anatomik Özelliklerinin Omuz Patolojileri İle İlişkisi

Yıl 2025, Cilt: 51 Sayı: 2, 271 - 275, 28.08.2025
https://doi.org/10.32708/uutfd.1621854

Öz

Bu çalışmanın amacı; supraspinatus tendonunun moment kolu uzunluğu ile omuz patolojileri arasındaki ilişkiyi değerlendirmektir. Kas-tendon moment kolu, bir kasın mekanik avantajını temsil eder ve dengeleyici veya ana taşıyıcı olarak rolünü büyük ölçüde belirler. Bu çalışmada, omuz Manyetik Rezonans görüntüleme kaydı bulunan 83 hastanın biseps ile rotator manşet kaslarının tendinozis ve yırtıkları, akromiyoklavikular eklemde dejenerasyon, kemik kisti gibi patolojiler araştırıldı. Humerus başının en geniş olduğu kesitte başın merkezi işaretlenerek eklem hareket merkezine dik bir çizgi çizilmiş ve bu uzunluk (B) ölçülmüştür. Rotator manşet ayak izinin eklem hareket merkezine uzaklığı (A) hesaplanmış ve ardından bu iki uzunluğun oranı (A/B) belirlenmiştir. Ayrıca, akromiyon sınıflandırılmış ve subakromiyal ile korakohumeral mesafeler ölçülmüştür. Elde edilen sonuçlara göre, moment kolu uzunluğu oranının (A/B) ortalaması 1,53 ± 0,11, subakromiyal mesafe ortalaması 8,56 ± 1,35 mm ve korakohumeral mesafe ortalaması 8,51 ± 1,51 mm olarak hesaplanmıştır. Moment kolu uzunluğu ile omuz çevresi patolojileri arasında tanımlayıcı, tanı ve tedavi sürecini etkileyebilecek anlamlı bir ilişki tespit edilmemiştir. Bununla birlikte, Tip 2 ve Tip 3 akromiyonların, Tip 1'e kıyasla daha dar bir subakromiyal mesafe oluşturduğu görülmüştür.Korakohumeral mesafe azaldıkça subskapular tendonda tendinozis ve yırtık görülme sıklığının arttığı, subakromiyal mesafenin azalması ile rotator manşet yırtıklarının görülme sıklığının arttığı belirlenmiştir. Sonuç olarak moment kolu uzunluğu, rüptür sonrası cerrahi onarımda önemli bir faktör olmasına rağmen, tanı için yol göstericiliği yoktur . Subakromiyal ve korakohumeral mesafeler ile rotator manşet tendon yırtıkları arasındaki ilişki, anatomik daralma ile tendon hasarının birbirini karşılıklı olarak etkileyebileceği çift yönlü bir ilişkiyi yansıtıyor olabilir.

Destekleyen Kurum

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Proje Numarası

-

Teşekkür

-

Kaynakça

  • 1. van der Heijden GJ. Shoulder disorders: a state-of-the-art review. Best Practice & Research Clinical Rheumatology.1999;13(2):287-309.
  • 2. Roy J-S, Braën C, Leblond J, et al. Diagnostic accuracy ofultrasonography, MRI and MR arthrography in thecharacterisation of rotator cuff disorders: a systematic reviewand meta-analysis. British journal of sports medicine.2015;49(20):1316-1328.
  • 3. Juul-Kristensen B, Bojsen-Møller F, Finsen L, et al. Musclesizes and moment arms of rotator cuff muscles determined bymagnetic resonance imaging. Cells Tissues Organs.2000;167(2-3):214-222.
  • 4. Maganaris CN. Imaging-based estimates of moment arm lengthin intact human muscle-tendons. European journal of appliedphysiology. 2004;91:130-139.
  • 5. Ackland DC, Pak P, Richardson M, et al. Moment arms of themuscles crossing the anatomical shoulder. Journal of anatomy.2008;213(4):383-390.
  • 6. Pandy MG. 4 Moment A rm of a Muscle Force. Exercise andsport sciences reviews. 1999;27(1):79-118.
  • 7. Oh JH, Kim JY, Lee HK, et al. Classification and clinicalsignificance of acromial spur in rotator cuff tear: heel-type spurand rotator cuff tear. Clinical Orthopaedics and RelatedResearch®. 2010;468(6):1542-1550.
  • 8. Tan V, Moore Jr RS, Omarini L, et al. Magnetic resonanceimaging analysis of coracoid morphology and its relation torotator cuff tears. American journal of orthopedics (Belle Mead, NJ). 2002;31(6):329-333.
  • 9. Heuberer PR, Plachel F, Willinger L, et al. Critical shoulderangle combined with age predict five shoulder pathologies: aretrospective analysis of 1000 cases. BMC musculoskeletaldisorders. 2017;18:1-9.
  • 10. Lu B. The morphology of the acromion and its relationship torotator cuff tear. Orthop Trans. 1986;10:228.
  • 11. Zhang Y, Herbert RD, Bilston LE, et al. Three‐dimensional architecture and moment arms of human rotator cuff muscles invivo: Interindividual, intermuscular, and intramuscular variations. Journal of Anatomy. 2024.
  • 12. Hughes RE, Niebur G, Liu J, et al. Comparison of two methodsfor computing abduction moment arms of the rotator cuff.Journal of biomechanics. 1997;31(2):157-160.
  • 13. Leschinger T, Birgel S, Hackl M, et al. A musculoskeletalshoulder simulation of moment arms and joint reaction forcesafter medialization of the supraspinatus footprint in rotator cuffrepair. Computer Methods in Biomechanics and BiomedicalEngineering. 2019;22(6):595-604.
  • 14. Wu H, Zuo Z, Li Y, et al. Anatomic characteristics of shoulderbased on MRI accurately predict incomplete rotator cuffinjuries in patients: relevance for predictive, preventive, andpersonalized healthcare strategies. EPMA J 2023:553-570.
  • 15. Yadav SK, Zhu WH. A systematic review: Of acromion typesand its effect on degenerative rotator cuff tear. InternationalJournal of Orthopaedics. 2017;3(1):453-458.
  • 16. Saupe N, Pfirrmann CW, Schmid MR, et al. Associationbetween rotator cuff abnormalities and reducedacromiohumeral distance. American Journal of Roentgenology.2006;187(2):376-382.
  • 17. Goutallier D, Le Guilloux P, Postel J-M, et al. Acromiohumeral distance less than six millimeter: its meaning in full-thickness rotator cuff tear. Orthopaedics & Traumatology:Surgery & Research. 2011;97(3):246-251.
  • 18. Seitz AL, Michener LA. Ultrasonographic measures ofsubacromial space in patients with rotator cuff disease: asystematic review. Journal of clinical ultrasound.2011;39(3):146-154.
  • 19. Çetinkaya M, Kaptan AY, Ulucaköy C, et al. Is it the subcoracoid impingement or the subacromial impingement thattears the subscapularis tendon? A comparison of the MRIfindings of the operated and healthy shoulders of the patients.Turk J Med Sci. 2023;53(1):273-281.
  • 20. Mi Y, Lin Y, Cheng B. Magnetic resonance imaging basedcoracoid process morphology and its associations with isolatedsubscapularis tendon tears in Chinese patients. Jt Dis RelatSurg. 2024;35(2):267-275.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Araştırma Makalesi
Yazarlar

İdris Demirtaş 0000-0002-7418-4207

Fatih Günaydın 0000-0003-1770-0276

Öner Kılınç 0000-0001-5119-3701

Bülent Sakarya 0000-0002-5000-4478

Proje Numarası -
Gönderilme Tarihi 19 Ocak 2025
Kabul Tarihi 20 Temmuz 2025
Yayımlanma Tarihi 28 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 51 Sayı: 2

Kaynak Göster

AMA Demirtaş İ, Günaydın F, Kılınç Ö, Sakarya B. The Relationship Between Supraspinatus Tendon Moment Arm Length, Shoulder Anatomical Features, and Shoulder Disorders. Uludağ Tıp Derg. Ağustos 2025;51(2):271-275. doi:10.32708/uutfd.1621854

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


Creative Commons License
Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023