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Cranial translation of the humeral head on radiographs in rotator cuff tear patients: the modified active abduction view

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Abstract

Cranial translation of the humeral head is related to massive rotator cuff tears; however, it may be unapparent in early-stage tears. The goal of this study was to investigate whether active abduction leads to increased active cranial humeral translation in early-stage tears. We assessed 20 consecutive patients (9 full-thickness supraspinatus tears, 11 posterosuperior tears) using the newly introduced modified active abduction view: acromiohumeral (AH) distance was measured on radiographs acquired during rest and active isometric abduction and adduction tasks with the arm alongside the body. Rest AH was 7.5 mm (SD = 1.53); during abduction and adduction, it decreased to 2.1 mm (95 % CI 1.28–3.01, p < 0.001) and 1.1 mm (95 % CI 0.46–1.65, p = 0.001), respectively. Cranial translation during abduction was more severe in shoulders with posterosuperior cuff tears (∆AH = 3 mm, SD = 1.5) compared to supraspinatus tears (∆AH = 1 mm, SD = 1.6), with a mean difference of 2 mm (95 % CI 0.64–3.58, p = 0.007). Both active isometric abduction and adduction leads to active cranial translation in cuff tear patients. Cranial translation is largest during active abduction. Furthermore, there is significant more cranial translation in posterosuperior cuff tear patients compared to supraspinatus cuff tear patients. Possibly, radiographs combined with active tasks offer new possibilities in diagnosing early-stage rotator cuff tears.

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Acknowledgments

We gratefully acknowledge the work of H. Fraterman for building the experimental setup. The institution of the authors has received funding from Dutch Arthritis Association (grant number 09-1-303).

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Authors and Affiliations

  1. Department of Orthopaedics, Leiden University Medical Center, Postzone J11-R, Postbus 9600, 2300 RC, Leiden, The Netherlands

    J. F. Henseler, P. B. de Witte, R. G. H. H. Nelissen & J. Nagels

  2. Department of Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands

    J. H. de Groot

  3. Department of Medical Statistics and BioInformatics, Leiden University Medical Center, Leiden, The Netherlands

    E. W. van Zwet

  4. Laboratory for Kinematics and Neuromechanics, Leiden University Medical Center, Leiden, The Netherlands

    J. F. Henseler, P. B. de Witte & J. H. de Groot

Authors
  1. J. F. Henseler
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  2. P. B. de Witte
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  3. J. H. de Groot
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  4. E. W. van Zwet
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  5. R. G. H. H. Nelissen
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  6. J. Nagels
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Correspondence to J. F. Henseler.

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Henseler, J.F., de Witte, P.B., de Groot, J.H. et al. Cranial translation of the humeral head on radiographs in rotator cuff tear patients: the modified active abduction view. Med Biol Eng Comput 52, 233–240 (2014). https://doi.org/10.1007/s11517-013-1057-2

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  • DOI: https://doi.org/10.1007/s11517-013-1057-2

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