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The Journal of Bone and Joint Surgery, Vol 74, Issue 1 53-66, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
The role of the rotator interval capsule in passive motion and stability of the shoulder
DT Harryman, JA Sidles, SL Harris and FA Matsen
Department of Orthopaedics, University of Washington, Seattle 98195.
The purpose of this study was to characterize the role of the capsule in
the interval between the supraspinatus and subscapularis tendons with
respect to glenohumeral motion, translation, and stability. We used a
six-degrees-of-freedom position-sensor and a six-degrees-of-freedom force
and torque-transducer to determine the glenohumoral rotations and
translations that resulted from applied loads in eight cadaver shoulders.
The range of motion of each specimen was measured with the capsule in the
rotator interval in a normal state, after the capsule had been sectioned,
and after it had been imbricated. Operative alteration of this capsular
interval was found to affect flexion, extension, external rotation, and
adduction of the humerus with respect to the scapula. Modification of this
portion of the capsule also affected obligate anterior translation of the
humeral head on the glenoid during flexion. Limitation of motion and
obligate translation were increased by operative imbrication and diminished
by sectioning of the rotator interval capsule. Passive stability of the
glenohumeral joint was evaluated with the use of anterior, posterior, and
inferior stress tests. Instability and occasional frank dislocation of the
glenohumeral joint occurred inferiorly and posteriorly after section of the
rotator interval capsule. Imbrication of this part of the capsule increased
the resistance to inferior and posterior translation.
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