Irreparable Rotator Cuff Tears: A Biomechanical Comparison of Superior Capsuloligamentous Complex Reconstruction Techniques and an Interpositional Graft Technique.

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 (

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.

Déclaration de conflit d'intérêts

The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.