Universität zu Köln

Leschinger, Tim ORCID: 0000-0003-1319-6949, Besch, Katharina, Aydin, Cansu, Staat, Manfred ORCID: 0000-0003-4363-6570, Scaal, Martin, Mueller, Lars Peter and Wegmann, Kilian (2019). Irreparable Rotator Cuff Tears: A Biomechanical Comparison of Superior Capsuloligamentous Complex Reconstruction Techniques and an Interpositional Graft Technique. Orthopaedic journal of sports medicine, 7 (8). THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 2325-9671

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Abstract

Background: Irreparable rotator cuff tears lead to superior translation of the humeral head. Numerous surgical management options are available to treat the condition. Purpose: To compare superior capsule stability among different types of patch grafting in irreparable rotator cuff tears. Methods: Six cadaveric shoulders were tested in a custom-designed shoulder testing system. Superior translation of the humerus and subacromial contact pressure were quantified in an intact condition (condition 1), after cutting the supraspinatus tendon (condition 2), and after additionally cutting the superior capsuloligamentous complex (condition 3). The results were compared among 3 types of patch grafting, in which capsule reconstruction was achieved by glenoidal 3-point (condition 4) or 2-point (condition 5) fixation or by affixing a graft below the acromion (condition 6). Results: No significant difference in subacromial pressure was measured by reconstruction with 2 or 3 anchors compared with conditions 1 and 2 (P > .05). However, with 3-point fixation, lower levels of pressure were measured than with 2-point fixation. Moreover, superior translation values were lower with 3-point fixation; the same applied for values of the preserved capsule as compared with the torn capsule. In condition 6, a significant increase in pressure in the neutral position was documented (P < .05). Conclusion: The superior capsuloligamentous complex plays an important role in stabilizing the glenohumeral joint. The results suggest that with additional medial anchoring at the coracoid base, the depressing and centering effect of the superior complex can probably be regained in a more physiological way compared with a reconstructed capsule with 2 glenoid attachments or with an interpositional graft below the acromion.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leschinger, Tim UNSPECIFIED orcid.org/0000-0003-1319-6949 UNSPECIFIED Besch, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Aydin, Cansu UNSPECIFIED UNSPECIFIED UNSPECIFIED Staat, Manfred UNSPECIFIED orcid.org/0000-0003-4363-6570 UNSPECIFIED Scaal, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145536
DOI:	10.1177/2325967119864590
Journal or Publication Title:	Orthopaedic journal of sports medicine
Volume:	7
Number:	8
Date:	2019
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	2325-9671
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Biochemie > Institut I für Biochemie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language CAPSULE RECONSTRUCTION; STABILITY; SPACER Multiple languages Orthopedics; Sport Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14553