Dataset Information

Technique for Double Row Superior Capsule Reconstruction with Dermal Allograft.

ABSTRACT: Superior capsular reconstruction (SCR) is increasingly being used as a procedure for addressing irreparable rotator cuff tears. The procedure was initially described for failed rotator cuff repairs where the retears are severely retracted and when grade 3-4 fatty infiltration and atrophy exist. The SCR procedure can also be considered for irreparable rotator cuff tears in patients that are either too young or too high demand to be appropriate candidates for arthroplasty. Early short and medium term follow up studies support SCR with favorable outcomes compared with other salvage procedures.

SUBMITTER: Loy BN

PROVIDER: S-EPMC6993533 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Technique for Double Row Superior Capsule Reconstruction with Dermal Allograft.

Loy Bo Nasmyth BN Owen Matthew T MT Reid John B JB Guttmann Dan D

Arthroscopy techniques 20191218 1

Superior capsular reconstruction (SCR) is increasingly being used as a procedure for addressing irreparable rotator cuff tears. The procedure was initially described for failed rotator cuff repairs where the retears are severely retracted and when grade 3-4 fatty infiltration and atrophy exist. The SCR procedure can also be considered for irreparable rotator cuff tears in patients that are either too young or too high demand to be appropriate candidates for arthroplasty. Early short and medium t ...[more]

PMID: 32021780

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Project description:PurposeTo investigate the potential for a suture tape-reinforcement technique to prevent elongation with repetitive use of a human dermal (HD) allograft traditionally used for superior capsule reconstruction in a biomechanical model.MethodsUsing 8 scapulae and humeri Sawbones models, the standard superior capsule reconstruction was performed using 8 HD allografts. Four grafts were tested in the native state, whereas 4 were tested using reinforcement. Allografts were reinforced using suture tape in a running 360° fashion around the allograft borders, maintaining 5 mm of space from the edges. Allografts were measured pre- and postdynamic testing for length, width, and thickness. All specimens were affixed to a materials testing machine that allowed for allograft orientation in a longitudinal plane throughout testing. Specimens were preloaded to 10 N and then cyclically loaded to 100 N at a rate of 15 mm/s for 30 cycles.ResultsAfter dynamic, cyclic loading, suture tape-reinforced allografts experienced a significantly smaller percent change in anterior length (6.36% vs 14.50%, P = .013), posterior length (6.00% vs 13.68%, P = .002), medial width (5.80% vs 21.05%, P = .001), lateral width (5.45% vs 19.29%, P < .001), medial thickness (4.38% vs 17.93%, P = .005), central thickness (7.03% vs 16.11%, P = .026), and lateral thickness (4.55% vs 20.80%, P < .001). Linear stiffness values obtained for suture tape -reinforced allografts were significantly greater than those for native allografts when measured at cycles 1 (21.18 ± 1.03 N/mm vs 17.69 ± 1.91 N/mm, P = .02), 15 (29.90 ± 1.45 vs 24.93 ± 2.79, P = .03), and 30 (32.13 ± 1.98 N/mm vs 25.72 ± 3.01 N/mm, P = .01) of dynamic testing.ConclusionsThe suture tape-reinforcement technique described decreased HD allograft elongation, maintained graft thickness, and improved linear stiffness values following uniplanar cyclic loading in a biomechanical Sawbones model.Clinical relevanceSuture tape reinforcement of the HD allograft could serve as one strategy to overcome the issue of allograft elongation with time following superior capsule reconstruction.

Dataset Information

Technique for Double Row Superior Capsule Reconstruction with Dermal Allograft.

Publications

Technique for Double Row Superior Capsule Reconstruction with Dermal Allograft.

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