On the kinematics of the cross body abduction and hand behind the back tests to assess osteoarthritis of the acromioclavicular joint
Keywords:Osteoarthritis, Acromioclavicular joint, MSC-ADAM
Background: Osteoarthritis of the acromioclavicular joint is one of the most common sources of shoulder pain. One of the current standard clinical physical examination tests is the cross body adduction test which has been shown to signal the presence of osteoarthritis. Another test referred to as the hand behind the back test has been described to provide a more accurate diagnosis than the CBA test for some patients. Through this work, both the CBA and the HBB tests were modeled in order to determine if there is merit for the HBB test to be used as a diagnostic tool for clinicians.
Methods: Both tests were modeled using the zygote solid 3D 50th percentile male human anatomy model and MSC-ADAMS Software to compile and run the simulations. Within MSC-ADAMS the bones were outfitted with joints. During simulation, the bones were moved from the anatomical position to the final position for each test and the corresponding minimum distances between the bones at the acromioclavicular joint were then determined.
Results: It was found that the distance between the acromioclavicular joint articulating surfaces decreased by 0.3 mm from the anatomical position during the CBA test and by 1.65 mm from the anatomical position during the HBB. This shows that the minimum space decreased from the anatomical position by more than 5 folds during the HBB test than during the CBA test.
Conclusions: These results indicate that the HBB test may be a better diagnostic test due to the greater stress and irritation it places upon the acromioclavicular joint.
Petersson CJ. Degeneration of the acromioclavicular joint. A morphological study. Acta Orthop Scand. 1983;54(3):434-8.
Horváth F, Kéry L. Degenerative deformations of the acromioclavicular joint in the elderly. Arch Gerontol Geriatr. 1984 Oct;3(3):259-65.
Buttaci CJ, Stitik TP, Yonclas PP, Foye PM. Osteoarthritis of the acromioclavicular joint: a review of anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil. 2004;83(10):791-7.
Clemente CD. Anatomy: a regional atlas of the human body. 6th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2011.
Gray H. Gray’s Anatomy: the anatomical basis of clinical practice. 41st ed. USA: Elsevier;2016.
Ranga A. Biomechanics of shoulder joint, in PMR PG Teaching. Available at: ttps://www.slideshare.net/ mrinaljoshi3/biomechanics-of-shoulder. Accessed on 20 November 2022.
Kuechle DK, Newman SR, Itoi E, Morrey BF, An KN. Shoulder muscle moment arms during horizontal flexion and elevation. J Shoulder Elbow Surg. 1997; 6(5):429-39.
Suenaga N, Minami A, Fujisawa H. Electromyographic analysis of internal rotational motion of the shoulder in various arm positions. J Shoulder Elbow Surg. 2003;12(5):501-5.
Soslowsky LJ, Cartmell JS. Basic science of the shoulder ligaments, in repair and regeneration of ligaments, tendons, and joint capsule. Walsh WR, eds. USA: Humana Press; 2016:107-32.
Osteoarthritis: In Depth. Available at: www.nccih. nih.gov/health/osteoarthritis-in-depth. Accessed on 20 November 2022.
Health Information on Osteoarthritis. Available at: www.niams.nih.gov/health-topics/osteoarthritis. Accessed on 20 November 2022.
Brandt KD, Dieppe P, Radin EL. Etiopathogenesis of osteoarthritis. Rheum Dis Clin North Am. 2008;34(3):531-59.
Felson DT, Neogi T. Osteoarthritis, in Harrison’s principles of internal medicine. New York: McGraw-Hill Education; 2018:2624-31.
Doherty M, Watt I, Dieppe P. Influence of primary generalised osteoarthritis on development of secondary osteoarthritis. Lancet. 1983 Jul 2;2(8340):8-11.
Bronner F, Carson F. Bone and osteoarthritis. 1st ed. Topics in Bone Biology. London: Springer London; 2007:4;43-9.
Warth RJ. Millett PJ. The acromioclavicular joint, in physical examination of the shoulder: an evidence-based approach. New York, NY: Springer; 2007:183-207.
Moseley HF. Athletic injuries to the shoulder region. Am J Surg. 1959;98:401-22.
Rockwood A, Matsen S. The shoulder. 5th ed. Philadelphia, PA: Elsevier; 2017.
Shaffer BS. Painful conditions of the acromioclavicular joint. J Am Acad Orthop Surg. 1999;7(3):176-88.
Shoulder hand behind back (HBB) flexibility test. Available at: https://www.bing.com/videos/search? q=20.%09Shoulder+Hand+Behind+Back+(HBB)+Flexibility+Test. Accessed on 20 November 2022.
The multibody dynamics simulation solution. Available at: www.mscsoftware.com/product/adams. Accessed on 20 November 2022.
3D CAD design software: solid works. Available at: www.solidworks.com. Accessed on 20 November 2022.
Solid 3D male model. Available at: www.zygote.com/cad-models/collections-products/ solid-3d-male-collection. Accessed on 20 November 2022.
Wobser AM, Adkins Z, Wobser RW. Anatomy, Abdomen and Pelvis, Bones (Ilium, Ischium, and Pubis). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
Herman IP. Physics of the human body. 2nd ed. USA: Springer;2016.
Chadwick EK, Blana D, Kirsch RF, van den Bogert AJ. Real-time simulation of three-dimensional shoulder girdle and arm dynamics. IEEE Trans Biomed Eng. 2014;61(7):1947-56.
Wang EL, Hull ML. A dynamic system model of an off-road cyclist. J Biomech Eng. 1997;119(3):248-53.
Edwards SL, Wilson NA, Flores SE, Koh JL, Zhang LQ. Arthroscopic distal clavicle resection: a biomechanical analysis of resection length and joint compliance in a cadaveric model. Arthroscopy. 2007;23(12):1278-84.
Zappia M, Castagna A, Barile A, Chianca V, Brunese L, Pouliart N. Imaging of the coracoglenoid ligament: a third ligament in the rotator interval of the shoulder. Skeletal Radiol. 2017;46(8):1101-11.