Effect of Partialthickness Tear of Supraspinatus on the Distribution of Tendon Stress:Finite Element Analysis
1.Rehabilitation Department,Tianshan Traditional Chinese Medicine Hospital of Changning District
2.Institute of Spine,Shanghai University of Traditional Chinese Medicine
Abstract:Objective To study the effect of partial-thickness tear of the supraspinatus tendon by finite element analysis.Methods The shoulder of volunteer was scanned by CT.The CT images were imported into Mimics 16.0,and segmented scapula,proximal humerus,supraspinatus muscle,and thenthe models were imported into Geomagic studio 2012 to fit the NURBS surface of the models.The supraspinatus tendon was divided into 3 regions.According to the damage depth,3 model were build (A group 20%,B group 40%,C group 60%).All models were meshed in Hypermesh 13.0,and normal supraspinatus muscle injury model was uesed as control.Through changing the relative position of glenoid humeral joint,the above models were fixed at different abduction degree (0°、30°、60°、90°).Then all models were exported to Abaqus 6.14.Results a)During the abduction of the shoulder,the middle region of the supraspinatus was the most stressed,followed by the anterior and posterior regions.b)With the increase of shoulder abduction angle,the stress produced by supraspinatus muscle was maximal at abduction of 30°,which was significantly different from other abduction angles (P<0.05).The stress of tendon in 90 °abduction angles was still significantly greater than that of 0°angles,and there was a significant difference (P<0.05).c) In the three groups of anterior and posterior region injury,the tendon stress in group C was significantly greater than that in group A and group B (P<0.01),and there was no significant difference between group A and B group (P>0.05).d) In the three groups of middle area injuries,the tendon stress in group B and group C was significantly greater than that in group A (P<0.01),and there was no significant difference between group B and group C (P>0.05).Conclusion The stress in the middle supraspinatus is significantly higher than that in the anterior and posterior regions.The depth of injury is 40% at the middle part of supraspinatus,and 60% at the anterior and posterior parts,that can cause the stress concentration around the injured tendons and extend to full thickness injury,that should be actively reconstructed.
[1]Morrison DS,Bigliani LU.The clinical significance of variations in acromial morphology[J].Orthop Trans,1986(11):234.
[2]Ellman H.Diagnosis and treatment of incomplete rotator cuff tears[J].Clin Orthop Relat Res,1990,(254):64-74.
[3]Engelhardt C,Ingram D,Müllhaupt P,et al.Effect of partialthickness tear on loading capacities of the supraspinatus tendon:a finite element analysis[J].Comput Method Biomec,2016,19(8):875-882.
[4]Thunes J,Matthew MR,Pal S,et al.The Effect of Size and Location of Tears in the Supraspinatus tendon on potential tear propagation[J].J Biomech Eng,2015,137(8):10121-10218.
[5]许苑晶,杨泽政,刘至原,等.肩袖的有限元建模及其生物力学分析[J].中华创伤骨科杂志,2017,19(4):279-285.
[6]Reilly P,Amis AA,Wallace AL,et al.Mechanical factors in the initiation and propagation of tears of the rotator cuff[J].J Bone Joint Sugrg Br,2003,85(4):594-599.
[7]朱鸣镝,汤锦波,高永静,等.冈上肌腱在肩关节外展时运动轨迹研究及临床意义探讨[J].中国临床解剖学杂志,2003,21(4):375-378.
[8]Fung YC.Biomechanicsmechanical properties of living tissues[J].Medical Physics,1982,9(5):788-789.
[9]章伟,芮碧宇,潘垚,等.新型锁定钢板与AO-PHILOS钢板固定肱骨近端四部分骨折的三维有限元分析[J].医用生物力学,2016,31(6):548-555.
[10]张琳琳,叶铭,王冬梅,等.肱骨外旋运动中盂肱关节面接触分析[J].上海交通大学学报,2008,42(5):807-811.
[11]邹海天.人体前臂软组织活体力学性质研究[D].哈尔滨:哈尔滨工业大学,2008.
[12]胡涛.,薛黔,李季蓉.人冈上肌肌形态、肌内神经和肌梭分布的研究[J].四川解剖学杂志,2009,17(4):9-11.
[13]王微,李剑,李红川,康汇.关节镜下穿肌腱技术治疗关节侧部分肩袖损伤[J].实用骨科杂志,2017,23(2):97-99,104.
[14]朱鸣镝,汤锦波,凌树才,等.肩关节运动时肌肉力臂改变的实验研究[J].中国临床医学,2007,14(2):221-225.