| description: |
Recent clinical and anatomical investigations have brought new insight into the ligamentous network of the shoulder joint capsule. In addition to the only officially recognized ligament of the sholuder joint, the Lig. coracohumerale, the so-called Ligg. semicirculare humeri, coracoglenoidale, glenohumerale spirale and glenocapsulare have been described as constant macroscopical structures. In addition, the Lig. coracohumerale itself has been described to be composed of two, the "superior" and "inferior parts"; the "inferior" with origin from Lig. coracoglenoidale and not from the base of the Processus coracoideus. At the same time there is no acceptable anatomical description of the Ligg. glenohumeralia, although their involvement into different pathological conditions is constantly discussed in the clinical literature. The involvement of the new ligaments into the network of the shoulder joint capsule changes our understanding of the blood supply and innervation of the whole glenohumeral joint. The tendons of the rotator-cuff melting into the joint capsule are due to physical overload, traumas or age-related degenerative changes often ruptured, causing pain and loose of the quality of life to the patient. The reason of the formation of the ruptures is not always clear. Within the M. supraspinatus tendon a "critical" avascular zone has been described by several authors, and the reason for the formation of the ruptures is ascribed to the avascular zone and corresponding changes within the cellular structure and the extracellular matrix of this region. In parallel there are opinions in the clinical literature, that there is primary no avascular zone within the M. supraspinatus tendon and its formation corresponds to the pathological changes in the tendon. The problem, which changes take place within the M.supraspinatus before the rupture remain unsolved. In addition to the M. supraspinatus the ruptures have been noticed within all the rotator-cuff tendons. The reason of their formation also remains unsolved. The blood supply and innervation of the shoulder joint has been poorly investigated; the blood supply and innervation of the new ligamentous structures has not been described. The planned clinical-morphological research will concentrate on the ruptures of the tendons, the "frozen shoulder" and formation of the SLAP, Hill-Sachs and Bankart lesions, that will give new opportunities for the medical treatment and rehabilitation of the different shoulder joint pathologies. |