Zachary D Vredenburgh1, John P Prodromo2, James E Tibone3, Taylor R Dunphy4, Joel Weber5, Michelle H McGarry6, Seungbum Chae7, Gregory J Adamson6, Thay Q Lee8. 1. Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA. 2. Princeton Orthopaedic Associates, Princeton, NJ, USA. 3. Department of Orthopaedic Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 4. Newport Orthopedic Institute, Newport Beach, CA, USA. 5. Evergreen Health Orthopedics & Sports Care, Kirkland, WA, USA. 6. Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA. 7. Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA; Department of Orthopaedic Surgery, Daegu Catholic University Hospital School of Medicine, Daegu, Republic of Korea. 8. Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA. Electronic address: tqlee@congressmedicalfoundation.org.
Abstract
BACKGROUND: We hypothesized that in a cadaveric massive rotator cuff tear (MCT) model, a fascia lata (FL) allograft superior capsular reconstruction (SCR) would restore subacromial contact pressure and humeral head superior translation without limiting range of motion (ROM). Therefore, the objective of this study was to compare these parameters between an intact rotator cuff, MCT, and allograft FL SCR. METHODS: Eight fresh cadavers were studied using a custom shoulder testing system. ROM, superior translation, and subacromial contact pressure were measured in each of 3 states: (1) intact rotator cuff, (2) MCT, and (3) MCT with SCR. RESULTS: Total ROM was increased in the MCT state at 60° of abduction (P = .037). FL SCR did not restrict internal or external rotational ROM. Increased superior translation was observed in the MCT state at 0° and 30° of humeral abduction, with no significant difference between the intact cuff and FL SCR states. The MCT state significantly increased mean subacromial contact pressure at 0° of abduction with 30° and 60° of external rotation, and FL SCR restored this to intact levels. Peak subacromial contact pressure was increased for the MCT state at 0° of abduction with 30° and 60° of external rotation, as well as 30° of abduction with 30° of external rotation. CONCLUSION: This study demonstrates a tensor FL allograft preparation technique for use in SCR. After MCT, FL SCR restores ROM, superior translation, and subacromial contact pressure to the intact state.
BACKGROUND: We hypothesized that in a cadaveric massive rotator cuff tear (MCT) model, a fascia lata (FL) allograft superior capsular reconstruction (SCR) would restore subacromial contact pressure and humeral head superior translation without limiting range of motion (ROM). Therefore, the objective of this study was to compare these parameters between an intact rotator cuff, MCT, and allograft FL SCR. METHODS: Eight fresh cadavers were studied using a custom shoulder testing system. ROM, superior translation, and subacromial contact pressure were measured in each of 3 states: (1) intact rotator cuff, (2) MCT, and (3) MCT with SCR. RESULTS: Total ROM was increased in the MCT state at 60° of abduction (P = .037). FL SCR did not restrict internal or external rotational ROM. Increased superior translation was observed in the MCT state at 0° and 30° of humeral abduction, with no significant difference between the intact cuff and FL SCR states. The MCT state significantly increased mean subacromial contact pressure at 0° of abduction with 30° and 60° of external rotation, and FL SCR restored this to intact levels. Peak subacromial contact pressure was increased for the MCT state at 0° of abduction with 30° and 60° of external rotation, as well as 30° of abduction with 30° of external rotation. CONCLUSION: This study demonstrates a tensor FL allograft preparation technique for use in SCR. After MCT, FL SCR restores ROM, superior translation, and subacromial contact pressure to the intact state.
Keywords:
Superior capsular reconstruction; allograft; biomechanics; rotator cuff tear; subacromial contact pressure; superior translation; tensor fascia lata
Authors: Hema J Sulkar; Tyler W Knighton; Linda Amoafo; Klevis Aliaj; Christopher W Kolz; Yue Zhang; Tucker Hermans; Heath B Henninger Journal: J Biomech Eng Date: 2022-05-01 Impact factor: 2.097