Dataset Information

Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis.

ABSTRACT:

Background

After rotator cuff repair, some surgeons use abduction pillows to unload or protect the repair construct, while others do not.

Question/purpose

The aim of this study was to determine which type of sling-one with a small or large abduction pillow or one without a pillow-places the repaired rotator cuff in the best position to reduce tension on the supraspinatus.

Methods

An X-ray study was performed on asymptomatic subjects to determine what position the shoulder is placed in when wearing a sling with or without an abduction pillow. Positions were then reproduced in human cadaveric shoulders using a custom-made testing jig, and tension on the repaired supraspinatus was measured.

Results

X-rays showed that abduction of the glenohumeral joint with a sling was only 4°, with a sling with a small pillow was 13°, and with a sling with a large abduction pillow was 25°. Placing the cadaveric shoulders in the position of a sling with a small abduction pillow caused a reduction in tension on the supraspinatus of 27% anteriorly and 55% posteriorly compared to placing the shoulder in the position of a sling without an abduction pillow; a large abduction pillow caused a further reduction in tension, of 42% anteriorly and 56% posteriorly.

Conclusion

These findings show that abduction pillows reduce tension on the repaired supraspinatus tendon.

SUBMITTER: Hawthorne JR

PROVIDER: S-EPMC6031537 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis.

Hawthorne Jacqueline R JR Carpenter Elise M EM Lam Patrick H PH Murrell George A C GAC

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20171226 2

<h4>Background</h4>After rotator cuff repair, some surgeons use abduction pillows to unload or protect the repair construct, while others do not.<h4>Question/purpose</h4>The aim of this study was to determine which type of sling-one with a small or large abduction pillow or one without a pillow-places the repaired rotator cuff in the best position to reduce tension on the supraspinatus.<h4>Methods</h4>An X-ray study was performed on asymptomatic subjects to determine what position the shoulder i ...[more]

PMID: 29983651

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Project description:The benefit of protective bracing after rotator cuff reconstruction has been debated for many years, although immobilization compliance has never been assessed objectively to date. In a previous study, compliance with the wearing of an abduction brace was measured for the first time with use of temperature-sensitive sensors. The purpose of the present follow-up study was to assess the effect of immobilization compliance on tendon-healing after rotator cuff repair.MethodsThe clinical and radiographic outcomes for 46 consecutive patients with objectively assessed abduction brace wearing compliance after arthroscopic repair of a superior rotator cuff tear were prospectively analyzed. Rotator cuff integrity was examined with ultrasound. Clinical outcomes were assessed with the relative Constant-Murley score (RCS), the Subjective Shoulder Value (SSV), and pain and patient satisfaction ratings. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value of abduction brace compliance for discriminating between shoulders that will and will not have a retear and the association of compliance with the failure of rotator cuff repair.ResultsAfter a mean duration of follow-up of 20 ± 9 months, the odds ratio for having a rotator cuff repair failure was 13-fold higher for patients with a compliance rate of <60% (p = 0.037). The retear rate was 3% (1 of 35 patients) in the high-compliance cohort (≥60% compliance) and 27% (3 of 11) in the low-compliance cohort (<60% compliance) (p = 0.037). No differences in RCS, SSV, pain, or postoperative patient satisfaction were observed between patients with ≥60% compliance and those with <60% compliance.ConclusionsPatients with a compliance rate of <60% had a 13-fold increase in the risk of rotator cuff retear. The 2 patients with the lowest compliance rates (11% and 22%) both had retears. Due to the small sample size, no final conclusions can be drawn regarding the influence of immobilization compliance on tendon-healing after rotator cuff repair. These findings justify a prospective trial with a larger cohort to confirm or disprove the value of compliance with abduction bracing.Level of evidenceTherapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Project description:Purpose To compare patient-reported and surgical outcome measures in patients with and without secondary shoulder stiffness (SSS) undergoing rotator cuff repair (RCR). Methods Patients undergoing rotator cuff repair from 2014 to 2020 with complete patient-reported outcome measures (PROMs) by the short-form 12 survey (SF-12) were retrospectively reviewed to identify if operative intervention for SSS was performed alongside the RCR. Those patients with operative intervention for SSS were propensity matched to a group without prior intervention for stiffness by age, sex, laterality, body mass index, diabetes mellitus status, and the presence of a thyroid disorder. The groups were compared by rotator cuff tear (RCT) size, surgical outcomes, further surgical intervention, rotator cuff retear rate, postoperative range of motion (ROM), and SF-12 results at 1 year after surgery. Delta values were calculated for component scores of the SF-12 and ROM values by subtracting the preoperative result from the postoperative result. Results A total of 89 patients with SSS were compared to 156 patients in the control group at final analysis. The patients in the SSS group experienced a significant improvement in the delta mental health component score (MCS-12) of the SF-12 survey that was not seen in the control group (P = .005 to P = .539). Both groups experienced significant improvement by the delta physical health component score (PCS-12) of the SF-12 survey (SSS: 7.68; P < .001; control: 6.95; P < .001). The SSS group also experienced greater improvement of their forward flexion (25.8° vs 12.9°; P = .005) and external rotation (7.13° vs 1.65°; P = .031) ROM than the control group. Conclusions Operative intervention of SSS at the time of RCR has equivalent postoperative SF-12 survey outcome scores when compared to patients undergoing RCR without preoperative stiffness despite those patients having lower preoperative scores. Level of Evidence Level III retrospective comparative study.

Dataset Information

Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis.

Background

Question/purpose

Methods

Results

Conclusion

Publications

Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis.

Similar Datasets

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