Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study

Abstract

Background:

Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements.

Purpose:

To evaluate the effect of experimental tissue alterations on clinical range of motion measures.

Study Design:

Controlled laboratory study.

Methods:

Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement.

Results:

There was a significant main effect of condition for bicipital forearm angle (P = .02, F = 4.03), low flexion (P = .02, F = 3.86), internal rotation (P = .03, F = 3.65), and external rotation (P < .001, F = 15.15) but not for horizontal adduction (P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline.

Conclusion:

Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations.

Clinical Relevance:

Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.

Keywords

capsular contracture retrotorsion shoulder tissue

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