Bursal Acromial Resurfacing Improves Shoulder Biomechanics in a Cadaveric Model of Massive Rotator Cuff Tear.

Autor:	Cho SH; Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea., Park CJ; Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea., Kim SJ; Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea., Lee KG; Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea., Baek GR; Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, U.S.A., Chung MS; Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, U.S.A., Hui AT; Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, U.S.A., McGarry MH; Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, U.S.A., Lee TQ; Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, U.S.A., Kim YS; Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: kysoos@catholic.ac.kr.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Jun 24. Date of Electronic Publication: 2024 Jun 24.
DOI:	10.1016/j.arthro.2024.06.019
Abstrakt:	Purpose: To investigate the effectiveness of bursal acromial resurfacing (acromiograft) on acromiohumeral distance, subacromial contact area, and pressure in a cadaveric model of massive rotator cuff tear. Methods: Eight fresh-frozen cadaveric shoulders were tested using a customized shoulder testing system. Humeral head translation, subacromial contact pressure, and the subacromial contact area were evaluated across 4 conditions: (1) intact shoulder; (2) simulated massive rotator cuff tear, (3) 3-mm acromiograft condition, and (4) 6-mm acromiograft condition. The acromiografts were simulated using Teflon and a reported technique. The values were measured at 0°, 20°, and 40° abduction and 0°, 30°, 60°, and 90° external rotation for each abduction status. Results: Compared with a massive cuff tear, the 6-mm acromiograft significantly reduced the superior translation of the humeral head at all abduction/external rotation angles (P < .05). The 3-mm acromiograft also decreased superior translation of the humeral head compared with massive cuff tear, but not all differences were significant. The 3- and 6-mm acromiografts significantly decreased the subacromial contact pressure and increased the subacromial contact area in almost all positions (P < .05). The 3-mm acromiograft maintained biomechanical properties similar to the intact condition, whereas the 6-mm acromiograft increased the contact area. Conclusions: This biomechanical study demonstrated that both 3- and 6-mm acromiografts using Teflon in a cadaveric model of a massive cuff tear resulted in recentering of the superiorly migrated humeral head, increased the subacromial contact area, and decreased the subacromial contact pressure. The 3-mm graft was sufficient for achieving the intended therapeutic effects. Clinical Relevance: The acromiograft can normalize altered biomechanics and may aid in the treatment of massive cuff tears. Because grafting the acromion's undersurface is new with limited clinical outcomes, further observation is crucial. Using a Teflon instead of an acellular dermal matrix allograft for bursal acromial resurfacing could yield different results, requiring careful interpretation. Competing Interests: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Y-S.K. reports personal fees and nonfinancial support from Corentec, outside the submitted work. Some equipment, drugs, or supplies were provided by Smith and Nephew. T.Q.L reports grants, personal fees, and nonfinancial support from Arthrex; personal fees from CONMED Linvatec; personal fees from Smith & Nephew, all outside the submitted work. All other authors (S-H.C., C-J.P., S-J.K, K-G.L., G.R.B, M-S.C., A.T.H., M.H.M.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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