Optimal tension of fascia lata graft with SuturePatch augmentation in superior capsule reconstruction for irreparable tears of the supraspinatus and infraspinatus tendons

TL;DR

This study finds that using a SuturePatch with SCR at 20° or 30° abduction helps restore shoulder stability without affecting motion after rotator cuff tears.

Contribution

The study identifies optimal tension for SuturePatch-augmented SCR in treating irreparable rotator cuff tears.

Findings

SCR with SuturePatch reduced superior glenohumeral translation and subacromial pressure after tears.

Shoulder abduction at 20° or 30° provided similar stability and motion outcomes.

Glenohumeral ROM remained comparable across all tested conditions.

Abstract

Postoperative graft tear is correlated with poor clinical outcome after superior capsule reconstruction (SCR) for irreparable rotator cuff tears. The objective of this study was to investigate the optimal tension of the SuturePatch, which has been developed to reinforce SCR.

Eight fresh-frozen cadaveric shoulders were tested by using a custom shoulder-testing system. Superior glenohumeral translation, subacromial peak contact pressure, and glenohumeral range of motion (ROM) were compared among 4 conditions: (1) intact; (2) irreparable supraspinatus and infraspinatus tears; (3) SCR using a thin fascia lata graft and SuturePatch augmentation performed at 20° glenohumeral abduction; and (4) SCR using the same graft with SuturePatch augmentation performed at 30° glenohumeral abduction.

Increased superior glenohumeral translation and subacromial peak contact pressure after creation of an irreparable supraspinatus and infraspinatus tendon tear significantly decreased after SCR with SuturePatch augmentation performed at both 20° and 30° glenohumeral abduction. Superior glenohumeral translation and subacromial peak contact pressure did not differ between 20° and 30° glenohumeral abductions. Internal rotation (P = .39-.99), external rotation (P = .61-.99), or total rotational ROM (P = .51-.99) were comparable between the irreparable supraspinatus and infraspinatus tendon tear condition and SCR with SuturePatch augmentation at both 20° and 30° glenohumeral abduction.

SCR with SuturePatch augmentation restored superior glenohumeral stability and maintained glenohumeral ROM. When the SuturePatch is used to augment the graft of SCR, 30° or 45° of shoulder abduction (equal to 20° or 30° of glenohumeral abduction) may provide the optimal tension for graft attachment to the glenoid medially and greater tuberosity laterally.

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