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Influence of additional weight carrying on load-induced changes after rotator cuff tears: an "in vivo" study

Croci, Eleonora. Influence of additional weight carrying on load-induced changes after rotator cuff tears: an "in vivo" study. 2023, Doctoral Thesis, University of Basel, Faculty of Medicine.

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Abstract

Rotator cuff tears are a very common age-related shoulder injury that can result in an unstable joint. A thorough understanding of the glenohumeral motion is still missing and inconsistent shoulder kinematics patterns have been reported. Some of the inconsistencies in the literature may arise from different analysis techniques, such as motion capture or 3D-to-2D model-to-image registration techniques. Motion capture is non-invasive and can thus be used in many participants, but skin movement and the lack of direct landmarks tracking can lead to inaccurate conclusions. In contrast, 3D-to-2D model-to-image registration techniques are very accurate, but are associated with high radiation exposure, due to the required computed tomography scans for the segmentation of the 3D bone models and the dual-plane fluoroscopy for dynamic acquisition. Hence, the applicability is limited on a small scale, and the results may be less generalisable. We thus focused our kinematic analysis solely on single-plane fluoroscopy. This allowed us to have a more accurate estimation of the kinematics than motion capture, but less ionising radiation than 3D-to-2D model-to-image registration techniques.
This thesis contains the protocol of our in vivo study on patients with unilateral rotator cuff tears and control subjects, along with an assessment method for shoulder kinematics using single-plane fluoroscopy, and the associated kinematic results of a 30° loaded and unloaded arm abduction test in the scapular plane. Further, load-induced changes in muscle activity during the same abduction test are presented. Incidental findings from magnetic resonance imaging of the shoulders were included in these analyses.
In particular, all images were labelled with five anatomical landmarks and a reference sphere. This method was first tested for intra- and interrater reliability with manual labelling of the landmarks and then further developed by means of an automatic landmark detection algorithm. With this automatic algorithm, upward-downward scapula rotation and superior inferior glenohumeral translation of all shoulders were examined. Load-induced kinematic changes occurred in scapula rotation, but not in glenohumeral translation in shoulders with rotator cuff tears. Scapular motion might thus play an important role in compensating for
rotator cuff tears. Associated load-induced changes in muscle activity were observed in all muscles analysed and differences between healthy and pathological shoulders were assessed.
Overall, this study shows that shoulder kinematics are load dependent and that changes in shoulder kinematics and muscle activity can already be observed at low abduction angles. Implementation of this 30° loaded abduction test in the clinic could provide important insight into the functional status of the shoulder and be used to guide treatment decisions.
Advisors:Mündermann, Annegret
Committee Members:Schären, Stefan and Müller, Andreas Marc and Seth, Ajay
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Spinale Chirurgie (Schären)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Spinale Chirurgie (Schären)
UniBasel Contributors:Mündermann, Annegret and Schären, Stefan
Item Type:Thesis
Thesis Subtype:Doctoral Thesis
Thesis no:15403
Thesis status:Complete
Number of Pages:xiv, 138
Language:English
Identification Number:
  • urn: urn:nbn:ch:bel-bau-diss154038
edoc DOI:
Last Modified:18 Jul 2024 04:30
Deposited On:17 Jul 2024 11:40

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