The effect of simulated scapular winging on glenohumeral joint translations

• Published in: Journal of shoulder and elbow surgery 2013-07, Vol.22 (7), p.986-992
• Main Authors: Mueller, Andreas M., MD, Entezari, Vahid, MD, Rosso, Claudio, MD, McKenzie, Brett, BS, Hasebrock, Andrew, Cereatti, Andrea, PhD, Della Croce, Ugo, PhD, DeAngelis, Joseph P., MD, Nazarian, Ara, PhD, Ramappa, Arun J., MD
• Format: Article
• Language: English
• Subjects: Athletic Injuries - prevention & control; Biomechanical Phenomena; Cadaver; dyskinesia; Humans; Joint Instability - physiopathology; joint motion; Male; Middle Aged; Models, Anatomic; Orthopedics; Range of Motion, Articular - physiology; ROC Curve; Rotation; scapula; Scapula - abnormalities; Scapula - physiopathology; Shoulder; Shoulder Joint - physiology; Sports; translation; winging
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2012.09.010

Hypothesis In this study, we aim to test whether scapular winging results in a significant change in glenohumeral translation in the initial phase of the throwing motion. Methods Six shoulders underwent an abbreviated throwing motion (ATM) from late cocking to the end of acceleration by use of a validated robotic system. The intact specimens were tested to establish a baseline. The position of the scapula was then affected to simulate scapular winging by placing a cylindrical wedge under the inferior angle of the scapula, and the ATM was performed again. For both conditions, the average glenohumeral translations and scapular rotations were plotted over time to calculate the area under the curve, as a representative of the overall glenohumeral translations and scapular rotations observed during the ATM. Results Throughout the motion, the winged scapulae showed, on average, 7.7° more upward rotation, 1.6° more internal rotation, and 5.3° more anterior tipping as compared with the baseline. The scapular position relative to the hanging arm was significantly different between the baseline and scapular winging conditions in all arm positions, except for maximal external rotation and the neutral position. Comparing the area under the curve at baseline and with scapular winging indicated that scapular winging significantly increased anterior translation of the glenohumeral joint whereas translation in the superior/inferior and medial/lateral directions did not result in a change in translation. Discussion These results may suggest a more important role of abnormalities in scapular position in predisposing throwing athletes to shoulder injuries of the anterior capsulolabral structures and consecutive glenohumeral instability.