The influence of arthroscopic subscapularis tendon and anterior capsular release on glenohumeral translation: A biomechanical model

Marquardt, Björn; Garmann, Stefan; Hurschler, Christof; Pötzl, Wolfgang; Steens, Wolfram; Witt, Kai-Axel; Steinbeck, Jörn

doi:10.1016/j.jse.2005.09.018

« Previous Next »Journal of Shoulder and Elbow Surgery
Volume 15, Issue 4 , Pages 502-508, July 2006

The influence of arthroscopic subscapularis tendon and anterior capsular release on glenohumeral translation: A biomechanical model

Björn Marquardt, MD
- Department of Orthopaedics, University Hospital of Münster, Münster, Germany
- Reprint requests: Björn Marquardt, MD, Department of Orthopaedics, University Hospital of Münster, Albert-Schweitzer Strasse 33, 48149 Münster, Germany
Stefan Garmann, MD
- Department of Orthopaedics, St Josef-Stift Sendenhorst, Sendenhorst, Germany
Christof Hurschler, PhD
- Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany
Wolfgang Pötzl, MD
- Department of Orthopaedics, University Hospital of Münster, Münster, Germany
Wolfram Steens, MD
- Department of Orthopaedics, University Hospital of Münster, Münster, Germany
Kai-Axel Witt, MD
- Shoulder and Sportsmedicine Practice-Clinic Münster, Münster, Germany.
Jörn Steinbeck, MD
- Shoulder and Sportsmedicine Practice-Clinic Münster, Münster, Germany.

The effect of an arthroscopic release of the intraarticular portion of the subscapularis tendon and the anterior capsule on glenohumeral translation was investigated in a cadaveric model. Ten human cadaveric shoulders with a mean age of 63.5 years (range, 52-79 years) were tested in a robot-assisted shoulder simulator. Joint translation was measured before and after an arthroscopic release of the intraarticular portion of the subscapularis tendon and a subsequent release of the anterior capsule at 0°, 30°, 60°, and 90° of glenohumeral elevation. Translation was measured in the anterior, anterior-inferior, and inferior directions under 20 N of applied load. Testing of the specimen revealed that the release of the intraarticular portion of the subscapularis tendon and the anterior capsule increased translation in all directions. Significant increases in translation were observed after release of the intraarticular portion of the subscapularis tendon in the midrange of motion. The influence of the arthroscopic capsular release, in conjunction with the release of the subscapularis tendon, was very high above 60° of elevation. The study indicates that the intraarticular component of the subscapularis tendon functions as a restraint to anterior-inferior translation primarily in the midrange of glenohumeral motion, whereas the anterior capsule adds anterior-inferior stability to the glenohumeral joint mainly above 60° of elevation.