| Autor: |
Inês Santos, Lieselotte Pichler, Maximilian M. Saller, Christoph Thorwächter, Julia Gertrud Müller, Hannes Traxler, Matthias F. Pietschmann, Mark Tauber, Peter E. Müller |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Shoulder and Elbow Surgery. 32:e71-e83 |
| ISSN: |
1058-2746 |
| Popis: |
The impact of size and shape of a supraspinatus tear on the strain of the intact rotator cuff and the kinematics of the shoulder is still unknown. This, however, can be relevant to the decision-making of whether surgical reconstruction is required to prevent an increase in tendon defect. In this study, the effect of tear width and shape on rotator cuff strain and glenohumeral kinematics was evaluated during active abduction.Twelve fresh-frozen cadaver shoulders with intact rotator cuff were used in this study. 50% and 100% wide (full-thickness) crescent-shaped (n = 6) and reverse L-shaped tears (n = 6) were created in the supraspinatus tendon and strain and kinematics were measured during active humeral elevation until 30°.Both tear shapes and sizes led to an increase in internal rotation, supraspinatus loading force and superior translation of the humerus. For the "100% wide" tear size, an anterior translation was observed in the "crescent-shaped" group, while in the "reverse L-shaped" group this translation occurred mainly in the posterior direction. Strain was higher in the infraspinatus during the first 25° of abduction in comparison with the supraspinatus tendon in both tear shape groups. An analysis of the anterior and posterior tear borders showed a higher strain concentration on the same side of the tear in the "50%" and "100% wide crescent-shaped" group.The influence of different tear shapes was evident in the translation in the anterior-posterior direction as both led to an oppositely directed translation of the humeral head. The strain analysis showed a stress-shielding effect of the infraspinatus at the beginning of the abduction. Therefore, special attention must be paid to correctly identify the tear extension and adequately reconstruct the rotator cuff footprint. Moreover, the constant location of the maximum strain in the "crescent-shaped tear" group may lead to an earlier progression in contrast to the "reverse L-shaped tear" group. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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