Biomechanical Assessment of a V-Shaped Semitendinosus Allograft Anterior Cable Reconstruction for Irreparable Rotator Cuff Tears

Denard, Patrick J.; Park, Maxwell C.; McGarry, Michelle H.; Adamson, Gregory J.; Lee, Thay Q.

doi:10.1016/j.arthro.2021.07.031

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…In addition, 13 studies—all except the Denard study ( 45 )— found a significant improvement in the superior translation of the humeral head following SCR. Of these, 10 studies reported that superior translation could be restored to intact rotator cuff by SCR ( 15 , 17 , 21 , 27 , 40 , 41 , 44 , 55 , 58 , 60 ). One study reported lower superior translation after SCR, compared to intact rotator cuff ( 59 ).…”

Section: Resultsmentioning

confidence: 99%

“…Subacromial peak contact pressure was reported in 12 studies ( 21 , 27 , 38 – 41 , 44 , 45 , 55 , 58 – 60 ). Of these, six studies noted a marked increase in subacromial peak contact pressure following the appearance of the irreparable rotator cuff tear ( 21 , 39 – 41 , 59 , 60 ).…”

Section: Resultsmentioning

confidence: 99%

“…of the humeral head following SCR. Of these, 10 studies reported that superior translation could be restored to intact rotator cuff by SCR(15, 17, 21,27, 40, 41,44, 55,58,60). One study reported lower superior translation after SCR, compared to intact rotator cuff(59).…”

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confidence: 99%

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Biomechanical outcomes of superior capsular reconstruction for irreparable rotator cuff tears by different graft materials-a systematic review and meta-analysis

et al. 2023

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BackgroundIrreparable rotator cuff tears (IRCT) are defined as defects that cannot be repaired due to tendon retraction, fat infiltration, or muscle atrophy. One surgical remedy for IRCT is superior capsular reconstruction (SCR), which fixes graft materials between the larger tuberosity and the superior glenoid.Patients and methodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria were followed for conducting the systematic review and meta-analysis. From their inception until February 25, 2022, Pubmed, Embase, and Cochrane Library's electronic databases were searched. Studies using cadavers on SCR for IRCT were also included. The humeral head's superior translation and subacromial peak contact pressure were the primary outcomes. The humeral head's anteroposterior translation, the kind of graft material used, its size, and the deltoid load were the secondary outcomes.ResultsAfter eliminating duplicates from the search results, 1,443 unique articles remained, and 20 papers were finally included in the quantitative research. In 14 investigations, the enhanced superior translation of the humeral head was documented in IRCTs. In 13 studies, a considerable improvement following SCR was found, especially when using fascia lata (FL), which could achieve more translation restraints than human dermal allograft (HDA) and long head of bicep tendon (LHBT). Six investigations reported a subacromial peak contact pressure increase in IRCTs, which could be rectified by SCR, and these studies found a substantial increase in this pressure. The results of the reduction in subacromial peak contact pressure remained consistent regardless of the graft material utilized for SCR. While there was a statistically significant difference in the change of graft material length between FL and HDA, the change in graft material thickness between FL and HDA was not significant. The humeral head's anterior-posterior translation was rising in IRCTs and could be returned to its original state with SCR. In five investigations, IRCTs caused a significant increase in deltoid force. Furthermore, only one study showed that SCR significantly decreased deltoid force.ConclusionWith IRCT, SCR might significantly decrease the glenohumeral joint's superior and anterior-posterior stability. Despite the risks for donor-site morbidity and the longer recovery time, FL is still the best current option for SCR.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Biomechanical outcomes of superior capsular reconstruction for irreparable rotator cuff tears by different graft materials-a systematic review and meta-analysis

et al. 2023

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“…Other joint-preserving procedures, including superior capsule reconstruction and cable reconstruction, have been proposed to treat MIRCTs. 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 However, our technique presents some advantages, including less surgical time, it is technically easier, and potential cost savings. A disadvantage is that as the rotator cuff is not repaired completely, our technique may not be preferable for young and active patients where the risk of progression is of greater concern.…”

Section: Discussionmentioning

confidence: 99%

A Technique for a Suture-Based Cable Reconstruction of an Irreparable Posterosuperior Rotator Cuff Tear

Adams

Pasqualini²,

Heidenthal³

et al. 2022

Arthroscopy Techniques

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“…Therefore, the threshold of middle deltoid force is very important. In previous biomechanical studies, the failure load of the middle deltoid was usually set to 80 N. ( Cline et al, 2021 ; Denard, et al, 2022 ; Tibone, et al, 2022 ). According to these suggestions, when installing the electric actuators matching the middle deltoid, we specially selected the electric actuators with a maximum range of 100 N. Via this electric actuator, when the biomechanical machine cannot complete 0–90° abduction, it means that the normal shoulder joint may not be able to complete the abduction of the shoulder joint in this certain situation, which is determined as a failure state in this study.…”

Section: Methodsmentioning

confidence: 99%

Relationship between the progression of posterosuperior rotator cuff tear size and shoulder abduction function: A cadaveric study via dynamic shoulder simulator

Wang

Kang

Jin

et al. 2022

Front. Bioeng. Biotechnol.

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Posterosuperior rotator cuff tear (PSRCT) is one of the most common shoulder disorders in elderly people’s daily life; however, the biomechanical relationship between PSRCT and shoulder abduction function is still controversial. In this study, a total of twelve freshly frozen cadaveric shoulders were included and tested in five conditions: intact rotator cuff, 1/3 PSRCT, 2/3 PSRCT, entire PSRCT, and global RCT. In each condition, extra load (0%, 45%, and 90% failure load) was sequentially added to the distal humerus, and the function of the remaining rotator cuff was mainly evaluated via the middle deltoid force (MDF) required for abduction. It is found that the peak MDF is required for abduction did not differ among the three PSRCT conditions (1/3 PSRCT: 29.30 ± 5.03 N, p = 0.96; 2/3 PSRCT: 29.13 ± 9.09 N, p = 0.98; entire PSRCT: 28.85 ± 7.12 N, p = 0.90) and the intact condition (29.18 ± 4.99 N). However, the peak MDF significantly differed between the global RCT (76.27 ± 4.94 N, p < 0.01) and all PSRCT and intact conditions. Under 45% failure load, the MDF of the entire PSRCT and global tear conditions were significantly increased compared with another status. With the 90% failure load, only the 1/3 PSRCT condition maintained the same shoulder function as the intact rotator cuff. These biomechanical testing jointly suggested that the weight-bearing ability of the shoulder significantly decreased as PSRCT progressed.

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Biomechanical Assessment of a V-Shaped Semitendinosus Allograft Anterior Cable Reconstruction for Irreparable Rotator Cuff Tears

Cited by 13 publications

References 29 publications

Biomechanical outcomes of superior capsular reconstruction for irreparable rotator cuff tears by different graft materials-a systematic review and meta-analysis

Biomechanical outcomes of superior capsular reconstruction for irreparable rotator cuff tears by different graft materials-a systematic review and meta-analysis

A Technique for a Suture-Based Cable Reconstruction of an Irreparable Posterosuperior Rotator Cuff Tear

Relationship between the progression of posterosuperior rotator cuff tear size and shoulder abduction function: A cadaveric study via dynamic shoulder simulator

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