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Titel:

Biomechanical Effect of Superior Capsule Reconstruction Using a 3-mm and 6-mm Thick Acellular Dermal Allograft in a Dynamic Shoulder Model.

Dokumenttyp:
Journal Article; Research Support, Non-U.S. Gov't
Autor(en):
Scheiderer, Bastian; Kia, Cameron; Obopilwe, Elifho; Johnson, Jeremiah D; Cote, Mark P; Imhoff, Florian B; Dyrna, Felix; Beitzel, Knut; Imhoff, Andreas B; Adams, Christopher R; Mazzocca, Augustus D; Morikawa, Daichi
Abstract:
PURPOSE: To biomechanically compare the effect of superior capsule reconstruction (SCR) using a 3- and 6-mm thick acellular dermal allograft for the treatment of irreparable rotator cuff tears. METHODS: Eight fresh-frozen cadaveric shoulders were tested using a dynamic shoulder model. Maximum abduction angle (MAA), glenohumeral superior translation (ghST), subacromial peak contact pressure (sPCP), and cumulative deltoid force (cDF) were compared among 4 conditions: (1) intact shoulder, (2) simulated irreparable rotator cuff tear (RCT), (3) SCR using a 3-mm-thick acellular dermal allograft, (4) SCR using a 6-mm-thick acellular dermal allograft. RESULTS: Compared with the intact state, simulated irreparable RCTs significantly decreased MAA (P < .001), while significantly increasing ghST (P = .001), sPCP (P < .001), and cDF (P < .001). SCR with a 3-mm-thick graft significantly increased MAA (P = .01) and decreased ghST (P = .01) compared with the RCT state, however, showed similar sPCP and cDF. Compared with the torn state, SCR with a 6-mm-thick graft significantly increased MAA (P < .001) and significantly decreased ghST (P < .001), sPCP (P < .001), and cDF (P = .001). Using a 6-mm-thick graft demonstrated similar MAA, ghST, sPCP, and cDF compared with the intact state. When comparing the 3-mm to the 6-mm thick graft, significant differences were found in ghST (P = .03), sPCP (P < .001), and cDF (P = .02). CONCLUSIONS: SCR with a 6-mm-thick acellular dermal allograft better restored normal glenohumeral joint position and forces compared with a 3-mm-thick graft for the treatment of irreparable RCTs. CLINICAL RELEVANCE: Graft thickness may affect the clinical success following SCR with commercially available dermal allografts. Using a thicker (>3 mm) graft was able to biomechanically better restore native glenohumeral joint properties.
Zeitschriftentitel:
Arthroscopy
Jahr:
2020
Band / Volume:
36
Heft / Issue:
2
Seitenangaben Beitrag:
355-364
Volltext / DOI:
doi:10.1016/j.arthro.2019.08.026
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/31791890
Print-ISSN:
0749-8063
TUM Einrichtung:
Fachgebiet Sportorthopädie (Prof. Imhoff)
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