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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Arthritis | Research article

Muscle volume imbalance may be associated with static posterior humeral head subluxation

Authors: Marian Mitterer, Nicholas Matis, Gernot Steiner, Imre Vasvary, Reinhold Ortmaier

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

The transverse force couple (TFC) of the rotator cuff (subscapularis vs. infraspinatus and teres minor muscle) is an important dynamic stabilizer of the shoulder joint in the anterior-posterior direction. In patients with posterior static subluxation of the humeral head (PSSH), decentration of the humeral head posteriorly occurs, which is associated with premature arthritis. We hypothesize that not only pathologic glenoid retroversion but also chronic muscle volume imbalance in the transverse force couple leads to PSSH.

Methods

A retrospective analysis of the TFC muscle volumes of 9 patients with symptomatic, atraumatic PSSH, within 8 were treated with glenoid correction osteotomy, was conducted. The imaging data (CT) of 9 patients/10 shoulders of the full scapula and shoulder were analyzed, and the muscle volumes of the subscapularis (SSC), infraspinatus (ISP) and teres minor muscles (TMM) were measured by manually marking the muscle contours on transverse slices and calculating the volume from software. Furthermore, the glenoid retroversion and glenohumeral distance were measured.

Results

The mean glenoid retroversion was − 16° (− 7° to − 31°). The observed mean glenohumeral distance was 4.0 mm (0 to 6.8 mm). Our study population showed a significant muscle volume imbalance between the subscapularis muscle and the infraspinatus and teres minor muscles (192 vs. 170 ml; p = 0.005). There was no significant correlation between the subscapularis muscle volume and the glenohumeral distance (r = 0.068), (p = 0.872).

Conclusion

The muscle volume of the SSC in patients with PSSH was significantly higher than the muscle volume of the posterior force couple (ISP and TMM). This novel finding, albeit in a small series of patients, may support the theory that transverse force couple imbalance is associated with PSSH.

Level of evidence

Level 4 – Case series with no comparison group.

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Title: Muscle volume imbalance may be associated with static posterior humeral head subluxation
Authors: Marian Mitterer
Nicholas Matis
Gernot Steiner
Imre Vasvary
Reinhold Ortmaier
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Arthritis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04146-3

At a glance: The STEP trials

Springer Medicine

Muscle volume imbalance may be associated with static posterior humeral head subluxation

Abstract

Background

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

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