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Nonlinear stress analysis of the supraspinatus tendon using three-dimensional finite element analysis

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

No studies have used stress analysis with finite element analysis (FEA) to determine the causes of and mechanisms underlying rotator cuff tears. Therefore, we performed a biomechanical evaluation of the changes in stress distribution on the rotator cuff using three-dimensional (3-D) FEA.

Methods

The 3-D FEA model of shoulder joint allowed for abduction angles of 0°, 45° and 90° from the plane of the scapula and included the anatomical insertion points of the three major rotator cuff tendons and the middle fibres of the deltoid muscle. Stress distribution of the supraspinatus tendon on 3-D FEA was validated by a comparison with cadaveric and two-dimensional finite element model.

Results

The principal stress peaked in the region approximately 1 cm proximal to the insertion of the supraspinatus tendon. Furthermore, the stress on the joint side increased at the anterior edge of the supraspinatus tendon at abduction angles of 45° and 90°.

Conclusion

There are differences in stress changes between the joint side and bursal side of the supraspinatus tendon within the angles of abduction. The maximal tensile stress was observed on the articular side of the anterior edge of the supraspinatus tendon at 90° abduction. Our results indicate that the difference in tensile stress between the two layers results in delamination and causes partial-thickness tears.

Level of evidence

Decision analysis, Level II.

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Acknowledgments

The authors thank the technicians at the Institute of Mechanical Systems Engineering and the Industrial Technology Center of Miyazaki for their valuable collaboration. This study was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan. No financial remuneration related to the subject of this article was received by the authors or by any member of their families.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Atsushi Inoue & Etsuo Chosa

  2. Department of Orthopaedic Surgery, Nozaki Higashi Hospital, 2105 Takason, Murasumi, Miyazaki, 880-0837, Japan

    Atsushi Inoue, Keisuke Goto & Naoya Tajima

Authors
  1. Atsushi Inoue
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  2. Etsuo Chosa
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  3. Keisuke Goto
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  4. Naoya Tajima
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Correspondence to Atsushi Inoue.

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Inoue, A., Chosa, E., Goto, K. et al. Nonlinear stress analysis of the supraspinatus tendon using three-dimensional finite element analysis. Knee Surg Sports Traumatol Arthrosc 21, 1151–1157 (2013). https://doi.org/10.1007/s00167-012-2008-4

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  • DOI: https://doi.org/10.1007/s00167-012-2008-4

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