The novel arthroscopic subscapular quadriceps tendon-bone sling procedure provides increased stability in shoulder cadavers with severe glenoid bone loss.
Arthroscopy
/ methods
Biomechanical Phenomena
Bone Transplantation
/ methods
Cadaver
Female
Humans
Joint Instability
/ physiopathology
Male
Middle Aged
Quadriceps Muscle
/ surgery
Rotation
Scapula
/ surgery
Shoulder Dislocation
/ physiopathology
Shoulder Joint
/ physiopathology
Tendons
/ transplantation
Arthroscopic sling procedure
Biomechanical cadaver study
Glenoid bone loss
Quadriceps tendon bone graft
Shoulder instability
Subscapular tendon
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
20
09
2019
accepted:
03
02
2020
pubmed:
16
2
2020
medline:
2
4
2021
entrez:
16
2
2020
Statut:
ppublish
Résumé
Treatment of anterior glenoid bone loss in patients with recurrent anterior shoulder instability is a challenge. The subscapular sling method with quadriceps tendon bone (QTB) graft is a modification of the subscapular sling with a semitendinosus (ST) graft. The aim of the study was to test the biomechanical stability of the QTB sling procedure in human shoulder cadavers with severe anterior glenoid bone loss. Fourteen cadaveric shoulders were tested with a force-moment-guided robot in three conditions: physiologically intact, anterior glenoid bone resection, and the subscapular sling procedure with a QTB graft. Joint stability was measured in anterior, anterior inferior and inferior directions in four glenohumeral joint positions: 0° and 60° of glenohumeral abduction, with each at 0° and 60° of external rotation. Maximum external rotation was measured at 0° and 60° glenohumeral abduction. Computer tomography scans were obtained preoperatively to plan the glenoid bone resection, as well as postoperatively to calculate the proportion of the glenoid bone actually resected. Significantly decreased translations were observed in the shoulders with the QTB sling compared to the intact joint and the glenoid bone loss model. No significant differences in maximum external rotation were observed between the three different conditions. This biomechanical study revealed a significant stabilizing effect of the arthroscopic subscapular QTB graft sling procedure in human shoulder cadavers without compromising external rotation. Clinical trials may reveal the usefulness of this experimental method.
Identifiants
pubmed: 32060592
doi: 10.1007/s00167-020-05900-1
pii: 10.1007/s00167-020-05900-1
pmc: PMC7862209
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
170-180Subventions
Organisme : Helse Midt-Norge
ID : Helse Møre og Romsdal
Organisme : Arthrex GmbH
ID : Lending of equipment and anchors, see acknowlegements
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