Dermal allograft superior capsule reconstruction biomechanics and kinematics
| Autor: | Mario H. Lobao, Roshan T. Melvani, Pooyan Abbasi, Anand M. Murthi, Brent G. Parks |
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| Rok vydání: | 2020 |
| Předmět: |
Shoulders
Kinematics Rotator Cuff Injuries 03 medical and health sciences 0302 clinical medicine Cadaver Medicine Humans Orthopedics and Sports Medicine Rotator cuff Acromion Range of Motion Articular 030222 orthopedics business.industry Shoulder Joint Biomechanics Capsule 030229 sport sciences General Medicine Allografts Biomechanical Phenomena medicine.anatomical_structure Cuff Humeral Head Surgery business Cadaveric spasm Nuclear medicine |
| Zdroj: | Journal of shoulder and elbow surgery. 30(9) |
| ISSN: | 1532-6500 |
| Popis: | Purpose To investigate the effect of a dermal allograft SCR on kinematics and joint pressure biomechanics immediately after simulated superior irreparable rotator cuff tear. Methods This controlled laboratory study tested eight fresh-frozen cadaveric shoulders using a custom test frame. Balanced loading configuration centered the humeral head on the glenoid, and unbalanced load created a force pulling the head towards the acromion. Experimental conditions included the intact rotator cuff, irreparable supraspinatus tear (ISST), and dermal allograft SCR. A digital sensor measured glenohumeral and subacromial contact pressure maps, and a microscribe measured acromion-humeral distance. Results Glenohumeral contact pressure of ISST was 175% (295±44 kPa; P=0.018) of the intact rotator cuff value (169±10 kPa) at 0o in the balanced condition and 176% (P=0.048) of intact at 30o. SCR decreased glenohumeral contact pressure to 110% (185±27 kPa; P=0.044) of intact at 0o and to 95% (P=0.034) at 30o. Unbalanced ISST contact pressure was 146% (365±23 kPa; P=0.009) of intact (250±24 kPa) at 0o and 122% (P=0.045) at 60o. SCR decreased contact pressures to 110% (274±21 kPa; P=0.039) of intact at 0o and to 89% (P=0.003) at 60o. ISST increased superior migration of the humeral head, decreasing the acromion-humeral distance by 3.0±0.6 mm (P=0.006) in the unbalanced condition at 0o. SCR increased the acromion-humeral distance to a value similar to that of the intact cuff (P=0.003). SCR significantly lowered subacromial pressures in the unbalanced condition. Conclusions In an irreparable supraspinatus tear model, the dermal allograft SCR showed competency in stabilizing the glenohumeral joint, decreasing glenohumeral and subacromial contact pressures, and increasing the acromion-humeral distance. Level of Evidence Basic Science Study; Biomechanics |
| Databáze: | OpenAIRE |
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