Improved restoration of biomechanical factors using a narrow-box shaped reconstruction compared to a wide one in superior capsular reconstruction for irreparable supraspinatus tendon tears: a biomechanical study using a static shoulder simulator.
Sebastian Wegmann, Stephanie Kahmann, Christoph Marchal, Tim Leschinger, Kilian Wegmann, Lars-Peter Mueller, Michael Hackl
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引用次数: 0
Abstract
Hypothesis and/or background: Extensive, irreparable rotator cuff tears remain a surgical challenge and multiple treatment options are proposed and currently in use. To biomechanically compare superior glenohumeral translation, subacromial contact pressures, and area in a box-shaped reconstruction using the long head of the biceps tendon (LHBT) in an irreparable supraspinatus tendon tear model.
Methods: Seven cadaveric shoulders (mean age 61 years; range 32-84 years; standard deviation 22.3) were tested with a custom testing rig used to evaluate superior translation; subacromial contact pressures; and areas at 0°, 30°, and 60° of glenohumeral abduction. Conditions tested included the native state; a complete tear of the supraspinatus tendon; a wide box-shaped, double-bundle LHBT superior capsular reconstruction (BS-SCR); and a narrow BS-SCR.
Results: Compared with the wide BS-SCR, the narrow BS-SCR had statistically significantly lower median contact pressure at 30° and 60°. The subacromial contact area showed a statistically significant difference at 0° (P = .001) and 30° (P = .004) for the narrow BS-SCR compared with the wide BS-SCR. At an abduction angle of 0°, the narrow BS-SCR could restore superior translation significantly better compared with the wide construct. For all angles, the wide and narrow BS-SCR increased the median subacromial distance statistically significantly. The contact areas in 30° and 60° of abduction were higher for all scenarios, both peaking in the intact state in 30° with approximately 600 mm2.
Conclusions: In comparison to a wide BS-SCR, a narrow BS-SCR using the LHBT has biomechanical advantages in regard to subacromial contact pressures, the subacromial contact areas, as well as the acromiohumeral distance. The width of the reconstruction, therefore, has a direct influence on the success of the technique.
期刊介绍：
The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
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