Mihata, Teruhisa; Bui, Christopher N H; Akeda, Masaki; Cavagnaro, Matthew A; Künzler, Michael; Peterson, Alexander B; McGarry, Michelle H; Itami, Yasuo; Limpisvasti, Orr; Neo, Masashi; Lee, Thay Q (2017). A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear. Journal of shoulder and elbow surgery, 26(12), pp. 2158-2166. Elsevier 10.1016/j.jse.2017.07.019
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BACKGROUND
Biomechanical and clinical success of the superior capsule reconstruction (SCR) using fascia lata (FL) grafts has been reported. In the United States, human dermal (HD) allograft has been used successfully for SCRs; however, the biomechanical characteristics have not been reported.
METHODS
Eight cadaveric shoulders were tested in 5 conditions: (1) intact; (2) irreparable supraspinatus tear; (3) SCR using FL allograft with anterior and posterior suturing; (4) SCR using HD allograft with anterior and posterior suturing; and (5) SCR using HD allograft with posterior suturing. Rotational range of motion, superior translation, glenohumeral joint force, and subacromial contact were measured at 0°, 30°, and 60° of glenohumeral abduction in the scapular plane. Graft dimensions before and after testing were also recorded. Biomechanical parameters were compared using a repeated-measures analysis of variance with Tukey post hoc test, and graft dimensions were compared using a Student t-test (P < .05).
RESULTS
Irreparable supraspinatus tear significantly increased superior translation, superior glenohumeral joint force, and subacromial contact pressure, which were completely restored with the SCR FL allografts. Both SCR HD allograft repairs partially restored superior translation and completely restored subacromial contact and superior glenohumeral joint force. The HD allografts significantly elongated by 15% during testing, whereas the FL allograft lengths were unchanged.
CONCLUSIONS
Single-layered HD SCR allografts partially restored superior glenohumeral stability, whereas FL allograft SCR completely restored the superior glenohumeral stability. This may be due to the greater flexibility of the HD allograft, and the SCR procedure used was developed on the basis of FL grafts.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery |
UniBE Contributor: |
Künzler, Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1058-2746 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Lilianna Bolliger |
Date Deposited: |
19 Mar 2018 09:28 |
Last Modified: |
05 Dec 2022 15:10 |
Publisher DOI: |
10.1016/j.jse.2017.07.019 |
PubMed ID: |
29146012 |
Uncontrolled Keywords: |
Superior capsule reconstruction allograft biomechanics cadaver study fascia lata human dermal subacromial contact pressure superior translation |
BORIS DOI: |
10.7892/boris.110193 |
URI: |
https://boris.unibe.ch/id/eprint/110193 |
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