Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon

Arai, Ryuzo; Mochizuki, Tomoyuki; Yamaguchi, Kumiko; Sugaya, Hiroyuki; Kobayashi, Masahiko; Nakamura, Takashi; Akita, Keiichi

doi:10.1016/j.jse.2009.04.001

« Previous Next »Journal of Shoulder and Elbow Surgery
Volume 19, Issue 1 , Pages 58-64, January 2010

Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon

Ryuzo Arai, MD
- Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
Tomoyuki Mochizuki, MD
- Section of Cartilage Regeneration, Tokyo Medical and Dental University, Tokyo, Japan
Kumiko Yamaguchi, MD
- Unit of Clinical Anatomy, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
Hiroyuki Sugaya, MD
- Shoulder and Elbow Service, Funabashi Orthopaedic Sports Medicine Center, Funabshi, Japan
Masahiko Kobayashi, MD
- Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
Takashi Nakamura, MD
- Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
Keiichi Akita, MD, PhD
- Unit of Clinical Anatomy, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
- Reprint requests: Keiichi Akita, MD, PhD, Unit of Clinical Anatomy, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138519, Japan.

published online 17 June 2009.

Background

Various findings in the lateral rotator interval to support the long head of the biceps tendon have been reported. The purpose of this study was to clarify the functional anatomy regarding the stabilization of the biceps tendon.

Material and methods

Twenty embalmed shoulders were used for anatomic study, and 5 specimens of the anterosuperior part of the glenohumeral joint were histologically studied.

Results

Anatomically, the most superior part of the subscapularis tendon was attached to the upper margin of the lesser tuberosity and extended as a thin tendinous slip to the fovea capitis of the humerus. The superior glenohumeral ligament ran spirally along the biceps tendon. Histologically, the superior glenohumeral ligament was attached to the tendinous slip. There was no clear boundary between the superior glenohumeral and coracohumeral ligament.

Conclusion

To keep the biceps tendon in place and stabilized, tension in the superior glenohumeral ligament and the buttress support of the most superior insertion point of the subscapularis from behind the ligament may be necessary.