Biomechanical characteristics of subscapularis-sparing approach for anatomic total shoulder arthroplasty
| Autor: | Aniruddh N. Nayak, Kellen Worhacz, Christopher P. Roche, Tom Vanasse, Jason J. Scalise, Ryan Simovitch, Neil Olmscheid, Robert L. Boudreaux, Marc C. Jacofsky |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Weight-Bearing 03 medical and health sciences Rotator Cuff 0302 clinical medicine Tensile Strength Load to failure medicine Cadaver Humans Orthopedics and Sports Medicine Range of Motion Articular Aged 030222 orthopedics business.industry Shoulder Joint Suture Techniques 030229 sport sciences General Medicine Middle Aged Arthroplasty Surgery Tendon medicine.anatomical_structure Arthroplasty Replacement Shoulder business Cadaveric spasm |
| Zdroj: | Journal of shoulder and elbow surgery. 27(1) |
| ISSN: | 1532-6500 |
| Popis: | Background A technique for retaining the superior 50% of the subscapularis insertion for anatomic total shoulder arthroplasty has been described. This cadaveric study biomechanically evaluates this subscapularis-sparing approach and compares it with a complete subscapularis release and repair technique to determine whether there is a higher load to failure. Materials and methods Twelve matched pairs of human cadaveric arms were distributed into 3 test groups. Group 1 consisted of specimens with and without a 100% subscapularis release. Group 2 consisted of specimens with and without an inferior 50% subscapularis release. Group 3 consisted of specimens with either an inferior 50% or 100% release of the subscapularis footprint and repair. All tendon repairs were performed using bone tunnels and sutures. Specimens were biomechanically tested using non-destructive cyclic and tensile failure-inducing loads. Results In matched pairs, the following comparative results were obtained: native intact subscapularis specimens exhibited a load to failure of 1341.20 ± 380.10 N compared with 380.10 ± 138.79 N in the 100% release specimens ( P = .029), native intact subscapularis specimens exhibited a load to failure of 1209.74 ± 342.18 N compared with 744.33 ± 211.77 N in the 50% release specimens ( P = .057), and 50% release and repair specimens exhibited a load to failure of 704.62 ± 165.53 N compared with 305.52 ± 91.39 N in the 100% release and repair group ( P = .029). Conclusion Preservation of the superior 50% of the subscapularis demonstrates a higher load to failure compared with complete subscapularis release and repair using bone tunnels. |
| Databáze: | OpenAIRE |
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