Functional categorization of the individual morphology of the scapula

A Matlab toolbox for scaled-generic modeling of shoulder and elbow

There still remains a barrier ahead of widespread clinical applications of upper extremity musculoskeletal models. This study is a step toward lifting this barrier for a shoulder musculoskeletal model by enhancing its realism and facilitating its applications. To this end, two main improvements are considered. First, the elbow and the muscle groups spanning the elbow are included in the model. Second, scaling routines are developed that scale model's bone segment inertial properties, skeletal morphologies, and muscles architectures according to a specific subject. The model is also presented as a Matlab toolbox with a graphical user interface to exempt its users from further programming. We evaluated effects of anthropometric parameters, including subject's gender, height, weight, glenoid inclination, and degenerations of rotator cuff muscles on the glenohumeral joint reaction force (JRF) predictions. An arm abduction motion in the scapula plane is simulated while each of the parameters is independently varied. The results indeed illustrate the effect of anthropometric parameters and provide JRF predictions with less than 13% difference compared to in vivo studies. The developed Matlab toolbox could be populated with pre/post operative patients of total shoulder arthroplasty to answer clinical questions regarding treatments of glenohumeral joint osteoarthritis.

Gender effect on the scapular 3D posture and kinematic in healthy subjects

Populations considered for shoulder analysis are often composed of various ratios of men and women. It is consequently hypothesized that gender has no significant effect on the joint kinematic. However, the literature reports, for the shoulder, differences in the range of motion between genders. The specific influence of gender on the scapulo-thoracic kinematics has not been studied yet. The dominant shoulder of two populations of men and women composed of 11 subjects each were evaluated in three dimensions for three distinct motions: flexion in the sagittal plane, abduction in the frontal plane and gleno-humeral internal/external rotation with the arm abducted at 90°. Posture, kinematics and range of motion were studied separately. For flexion and abduction and with regard to the scapular kinematic, external rotation was significantly larger for women than men. The differences were of at least 5° at 120° of humeral elevation. Upward rotations were identical. Women also showed larger average active humero-thoracic range of motion. The mean differences were of 13°, 7°, 12° and 5° for abduction, flexion, internal rotation and external rotation, respectively. No difference was observed between the scapular resting positions of both populations. The observed differences concerning both the scapular and humeral patterns would indicate that the shoulder behaviour of men and women should not be expected to be similar.

Musculoskeletal shoulder models: A technical review and proposals for research foci

Musculoskeletal shoulder models allow non-invasive prediction of parameters that cannot be measured, particularly the loading applied to morphological structures and neurological control. This insight improves treatment and avoidance of pathology and performance evaluation and optimisation. A lack of appropriate validation and knowledge of model parameters’ accuracy may cause reduced clinical success for these models. Instrumented implants have recently been used to validate musculoskeletal models, adding important information to the literature. This development along with increasing prevalence of shoulder models necessitates a fresh review of available models and their utility. The practical uses of models are described. Accuracy of model inputs, modelling techniques and model sensitivity is the main technical review undertaken. Collection and comparison of these parameters are vital to understanding disagreement between model outputs. Trends in shoulder modelling are highlighted: validation through instrumented prostheses, increasing openness and strictly constrained, optimised, measured kinematics. Future directions are recommended: validation through focus on model sub-sections, increased subject specificity with imaging techniques determining muscle and body segment parameters and through different scaling and kinematics optimisation approaches.

A geometric morphometric study into the sexual dimorphism of the human scapula

Sex determination is vital when attempting to establish identity from skeletal remains. Two approaches to sex determination exists: morphological and metrical. The aim of this paper was to use geometric morphometrics to study the shape of the scapula and its sexual dimorphism. The sample comprised 45 adult black male and 45 adult black female scapulae of known sex. The scapulae were photographed and 21 homologous landmarks were plotted to use for geometric morphometric analysis with the 'tps' series of programs, as well as the IMP package. Consensus thin-plate splines and vector plots for males and females were compared. The CVA and TwoGroup analyses indicated that significant differences exist between males and females. The lateral and medial borders of females are straighter while the supraspinous fossa is more convexly curved than that of males. More than 91% of the females and 95% of the males were correctly assigned. Hotelling's T(2)-test yielded a significant p-value of 0.00039. In addition, 100 equidistant landmarks representing the curve only were also assigned. These, however, yielded considerably poorer results. It is concluded that it is better to use homologous landmarks rather than curve data only, as it is most probable that the shape of the outline relative to the fixed homologous points on the scapula is sexually dimorphic.

Shoulder biomechanics: today's consensus and tomorrow's perspectives

Shoulder biomechanics is a fast growing field, which is progressively expanding its focus to include more applied research. The papers included in this Special Issue confirm this trend. After a classification of the papers as dealing with fundamental or applied research through theoretical or experimental methods, in this Editorial we tried to summarize the elements of consensus and the open issues discussed during the last International Shoulder Group meeting, held in Bologna (Italy) in 2008.