Humeral attachment of the supraspinatus and infraspinatus tendons: an anatomic study

Abstract

We investigated the anatomic relationship of the supraspinatus (SSP) and infraspinatus (ISP) tendons to the three facets of the greater tuberosity. After removing the superficial layer of the cuff to expose the tendon fibers in 10 embalmed shoulders, the cuff tendon attachment to the facets was examined, and the location of attachment was measured in reference to (1) the anterior margin of the greater tuberosity and (2) the superior margin of the sulcus (anatomic neck without cartilage). The SSP tendon attached to the superior facet and the superior half of the middle facet. The ISP tendon attached to the entire middle facet, covering a portion of the SSP tendon. Thus, the anterior half of the superior cuff tendon (12.6 +/- 1.1 mm) was composed of only the SSP tendon, whereas the posterior half (9.8 +/- 3.2 mm) was composed of both the SSP and ISP tendons. The sulcus was located not at the SSP-ISP interval but slightly posterior to the posterior margin of the SSP tendon (4.3 +/- 2.4 mm). We conclude that (1) there is an overlap between the SSP and ISP tendons identifiable by the facets or the distance from the anterior greater tuberosity and (2) the sulcus is located slightly posterior to the posterior margin of the SSP tendon.