Muscle Architecture Properties of the Deep Region of the Supraspinatus: A Cadaveric Study.

BACKGROUND

The supraspinatus is most frequently involved in rotator cuff tears, a common orthopaedic condition. However, the architecture of this muscle has been described only for the superficial, anterior, and posterior regions.

PURPOSE

To determine the muscle architecture of the deep supraspinatus.

STUDY DESIGN

Descriptive laboratory study.

METHODS

Muscle architecture measurements were collected from 25 cadaveric supraspinatus specimens (13 intact [without tendon tears], 3 with partial-thickness tears, 9 with full-thickness tears). The muscle was divided into deep, superficial anterior, and superficial posterior regions. Pennation angle, raw and normalized fiber length, and sarcomere length and number were compared using repeated-measures analyses of variance.

RESULTS

First, mean architecture measurements were compared between regions using only the intact specimens (n = 13). The deep region had a lower mean pennation angle (3.3° ± 1.0°) compared with the posterior region (11.0° ± 3.9°; < .0001), which in turn had a significantly higher pennation angle compared with the anterior region (7.6 ± 2.6°; = .0005). Normalized fiber lengths in the deep region were 21.1% ( = .0052) and 34.5% ( < .0001) shorter than the posterior and anterior normalized fiber lengths, respectively. Sarcomere lengths in the deep region were longer (3.4 ± 0.2 μm) compared with the posterior (3.1 ± 0.2 μm; = .0012) and anterior (3.2 ± 0.2 μm; = .0390) regions. Sarcomere numbers also decreased in the deep region by 21.2% ( = .0056) and 34.2% ( < .0001) compared with the posterior and anterior regions, respectively.

CONCLUSION

The deep supraspinatus had significantly lower pennation angles, shorter fiber lengths, and fewer but longer sarcomeres in series compared with other subregions within the muscle. These structural differences suggest a functionally unique "submuscle" within the supraspinatus.

CLINICAL RELEVANCE

Understanding the architecture of the supraspinatus muscle can provide insight into muscle function in health and disease. Specifically, this deep submuscle may play a different role in rotator cuff function than the rest of the muscle.