Arthroscopy. 2021 Nov 13:S0749-8063(21)00982-8. doi: 10.1016/j.arthro.2021.11.007. Online ahead of print.
ABSTRACT
PURPOSE: To compare the biomechanical effects of superior capsule reconstruction graft fixation length determined at 20° and 40° glenohumeral (GH) abduction. .
METHODS: Humeral translation, rotational range of motion (ROM) and subacromial contact pressure were quantified at 0°, 30°, and 60° of GH abduction in the scapular plane in 6 cadaveric shoulders for: intact; massive rotator cuff tear; SCR with a dermal allograft fixed at 20° GH abduction (SCR 20); and SCR fixed at 40° GH abduction (SCR 40). Statistical analysis was conducted using repeated measures ANOVA and paired t-test (P < 0.05).
RESULTS: Massive cuff tear significantly increased total ROM compared to intact at 0° and 60° abduction. SCR 20 or SCR 40 did not affect ROM. Compared to intact, the massive cuff tear significantly increased superior translation an average of 4.6 ± 0.5 mm at 9/12 positions (P ≤ 0.002). Both SCR 20 and SCR 40 reduced superior translation compared to massive cuff tear (P < 0.05); however, SCR 40 significantly decreased superior translation compared to SCR 20 at 0° abduction (P ≤ 0.046). Peak subacromial pressure for massive cuff tear increased an average of 486.8 ± 233.9 kPa relative to intact at 5/12 positions (P ≤ 0.037).; SCR 20 reduced peak subacromial pressure at 2/12 positions (P ≤ 0.012) while SCR 40 achieved this at 6/12 (P ≤ 0.024).
CONCLUSION: SCR with dermal allograft fixed at 20° or 40° of GH abduction decreases GH translation and subacromial pressure without decreasing range of motion.
PMID:34785299 | DOI:10.1016/j.arthro.2021.11.007
