Shoulder kinematics in 25 patients with impingement and 12 controls

We used dynamic radiostereometry to study the three-dimensional kinematics of the shoulder joint during active abduction. Twenty-five patients experiencing shoulder symptoms (Neer Stage 2) for more than 18 months, without total rotator cuff tears, participated. Eight men and four women without shoulder symptoms constituted controls. The rotation of the humeral head relative to a fixed scapula and the absolute rotation of the humerus (caused by humeral, scapular, and trunk motion) were measured. The rotations were calculated in the order of abduction/adduction (anteroposterior axis), internal/external rotation (longitudinal axis), and flexion/extension (transverse axis). The absolute abduction of the humerus in our patients did not differ from controls, nor did the abduction in the glenohumeral joint. During abduction, the humeral centre displaced medially, proximally, and anteriorly. In the patient group, slightly more (1-1.5 mm) proximal translation was observed. Presence of impingement syndrome was associated with increased proximal translation of the humeral head center, which occurred in the early phase of the arc of motion.

Diagnostic Level I. See Guidelines for Authors for a complete description of Levels of Evidence.