{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:32:14Z","timestamp":1790519534438,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,5,23]],"date-time":"2012-05-23T00:00:00Z","timestamp":1337731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>No studies have used stress analysis with finite element analysis (FEA) to determine the causes of and mechanisms underlying rotator cuff tears. Therefore, we performed a biomechanical evaluation of the changes in stress distribution on the rotator cuff using three\u2010dimensional (3\u2010D) FEA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 3\u2010D FEA model of shoulder joint allowed for abduction angles of 0\u00b0, 45\u00b0 and 90\u00b0 from the plane of the scapula and included the anatomical insertion points of the three major rotator cuff tendons and the middle fibres of the deltoid muscle. Stress distribution of the supraspinatus tendon on 3\u2010D FEA was validated by a comparison with cadaveric and two\u2010dimensional finite element model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The principal stress peaked in the region approximately 1\u00a0cm proximal to the insertion of the supraspinatus tendon. Furthermore, the stress on the joint side increased at the anterior edge of the supraspinatus tendon at abduction angles of 45\u00b0 and 90\u00b0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are differences in stress changes between the joint side and bursal side of the supraspinatus tendon within the angles of abduction. The maximal tensile stress was observed on the articular side of the anterior edge of the supraspinatus tendon at 90\u00b0 abduction. Our results indicate that the difference in tensile stress between the two layers results in delamination and causes partial\u2010thickness tears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Decision analysis, Level II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2008-4","type":"journal-article","created":{"date-parts":[[2012,5,22]],"date-time":"2012-05-22T06:42:32Z","timestamp":1337668952000},"page":"1151-1157","source":"Crossref","is-referenced-by-count":43,"title":["Nonlinear stress analysis of the supraspinatus tendon using three\u2010dimensional finite element analysis"],"prefix":"10.1002","volume":"21","author":[{"given":"Atsushi","family":"Inoue","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Orthopedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine University of Miyazaki 5200 Kihara, Kiyotake 889\u20101692 Miyazaki Japan"},{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Nozaki Higashi Hospital 2105 Takason, Murasumi 880\u20100837 Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuo","family":"Chosa","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Orthopedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine University of Miyazaki 5200 Kihara, Kiyotake 889\u20101692 Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Goto","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Nozaki Higashi Hospital 2105 Takason, Murasumi 880\u20100837 Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Tajima","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Nozaki Higashi Hospital 2105 Takason, Murasumi 880\u20100837 Miyazaki 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