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Biomechanical Comparison of 3 Glenoid-Side Fixation Techniques for Superior Capsular Reconstruction.

Biomechanical Comparison of 3 Glenoid-Side Fixation Techniques for Superior Capsular Reconstruction.

Authors :
Pogorzelski J
Muckenhirn KJ
Mitchell JJ
Katthagen JC
Schon JM
Dahl KD
Hirahara AM
Dines JS
Adams CR
Dooney T
Denard PJ
Turnbull TL
Millett PJ
Source :
The American journal of sports medicine [Am J Sports Med] 2018 Mar; Vol. 46 (4), pp. 801-808. Date of Electronic Publication: 2017 Dec 27.
Publication Year :
2018

Abstract

Background: Superior capsular reconstruction (SCR) was recently introduced as a treatment for irreparable superior rotator cuff tears in younger patients. Purpose/Hypothesis: The purpose was to assess the biomechanical strength of 3 methods for fixation of the graft to the glenoid for SCR. It was hypothesized that a 4-anchor technique would provide greater load to failure than 3-anchor techniques.<br />Study Design: Controlled laboratory study.<br />Methods: Thirty-six cadaveric specimens were randomized into 3 groups of previously established glenoid-side graft fixation techniques: (1) three 3.5-mm knotless screw-in anchors, (2) three 3.0-mm knotless push-in anchors, and (3) a 4-anchor hybrid construct with two 3.0-mm knotted push-in anchors and two 2.9-mm knotless push-in anchors. The repairs were cyclically loaded at 0.5 Hz from 10 to 200 N, then pulled to failure. Elongation, stiffness, maximum load at failure, and mode of failure were recorded and calculated.<br />Results: There were no significant differences in graft elongation or stiffness among the 3 techniques ( P > .37 and P > .26, respectively). Maximum load to failure was significantly greater in technique 1 (mean ± SD, 427.85 ± 119.70 N) than technique 3 (319.5 ± 57.60 N) ( P = 0.024). There were no significant differences in load to failure between techniques 1 and 2 or between techniques 2 and 3.<br />Conclusion: Glenoid-side graft fixation with 3 threaded 3.5-mm suture anchors showed a significant superior pull-out strength when compared with a 4-anchor hybrid technique and thus might be recommended in SCR for patients with irreparable superior rotator cuff tears to achieve maximum stability.<br />Clinical Relevance: SCR presents a novel alternative for treatment of irreparable superior rotator cuff tears in younger patients. Glenoid fixation is essential to provide adequate fixation of the graft to prevent the humeral head from rising and to restore normal biomechanics.

Details

Language :
English
ISSN :
1552-3365
Volume :
46
Issue :
4
Database :
MEDLINE
Journal :
The American journal of sports medicine
Publication Type :
Academic Journal
Accession number :
29281797
Full Text :
https://doi.org/10.1177/0363546517745626