Retracted: The clinical anatomy of the insertion of the rotator cuff tendons
2nd March 2017 - Article Retracted
The Article THE CLINICAL ANATOMY OF THE INSERTION OF THE ROTATOR CUFF TENDON has been retracted from the Anatomy Journal of Africa on author request, and on the understanding that it was concurrently submitted and published in another journal.
The rotator cuff (RC) insertions according to most anatomical texts are described as being separate. However, clear fusion of the RC tendon fibres exist with prior studies showing an interdigitation forming a common, continuous insertion onto and around the lesser- and greater tubercles (LT & GT) of the humerus. Current surgical repair methods (arthroscopic techniques), rarely mention or consider these connections during repair. Rotator cuff surgery remains a controversial subject, due to various available techniques, surgeon experience and preference and, the contradicting success rates. Therefore, the purpose of this project was to visualise and define the RC footprint and extension insertions with the aim of enhancing and improving knowledge of the basic anatomy in the hope that this will be considered during orthopaedic repair. Twenty shoulders (16 cadaveric & 4 fresh) were used in the study. The fresh shoulders were received from the National Tissue Bank and ethical clearance was obtained (239/2015). Reverse dissection was performed to visualise the RC unit exposing the interdigitated rotator hood (extension insertions), as well as the complete RC unit (tendons + internal capsule) separated from the scapula and humerus. Once the insertions were exposed and documented, the RC muscle footprint (articular surface area) was measured and recorded, using AutoCAD 2016. No statistical significant difference between left and right (p = 0.424) was noted, but a significant difference between males and females (p = 0.000) was. These findings indicate evidence that the RC tendons and the internal capsule are one complete and inseparable unit. The fact that the RC unit is more complex in its structure and attachment places importance on the biomechanical stresses encountered after repair. Functions of one RC muscle are not necessarily isolated but can be influenced by surrounding muscles as well. These findings also provide clarity for surgeons with the goal of improving and enhancing surgical methods for better post-operative patient outcome.
Keywords: Orthopaedic; arthroscopic; re-tear; complex; reverse dissection; capsule