Universität zu Köln

Hackl, Michael, Buess, Eduard, Kammerlohr, Sandra, Nacov, Julia, Staat, Manfred ORCID: 0000-0003-4363-6570, Leschinger, Tim, Muller, Lars P. and Wegmann, Kilian (2021). A Comma Sign-Directed Subscapularis Repair in Anterosuperior Rotator Cuff Tears Yields Biomechanical Advantages in a Cadaveric Model. Am. J. Sports Med., 49 (12). S. 3212 - 3218. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 1552-3365

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Abstract

Background: Additional stabilization of the comma sign in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign-directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P <= .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Buess, Eduard UNSPECIFIED UNSPECIFIED UNSPECIFIED Kammerlohr, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Nacov, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Staat, Manfred UNSPECIFIED orcid.org/0000-0003-4363-6570 UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Muller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-579255
DOI:	10.1177/03635465211031506
Journal or Publication Title:	Am. J. Sports Med.
Volume:	49
Number:	12
Page Range:	S. 3212 - 3218
Date:	2021
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	1552-3365
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ARTHROSCOPIC REPAIR; TENDON TEARS; INTEGRITY; INSERTION Multiple languages Orthopedics; Sport Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57925