Superior capsule reconstruction using 8mm-thick fresh-frozen fascia lata graft for irreparable supraspinatus and infraspinatus tendon tears: A cadaveric biomechanical study.

IF 1.5 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2025-03-12 DOI:10.1016/j.jos.2025.02.007
Teruhisa Mihata, Christen E Chalmers, Joseph Carbone, Mauro Maniglio, Michael Künzler, Nilay A Patel, Michelle H McGarry, Thay Q Lee
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引用次数: 0

Abstract

Background: Superior capsule reconstruction (SCR) was developed to restore superior glenohumeral stability and function to shoulder joints with irreparable rotator cuff tears. Previous biomechanical studies have investigated the effects of SCR using dermal graft or freeze-dried fascia lata allograft. The objective of the current study was to investigate the effect of SCR using fresh-frozen fascia lata graft, which closely resembles the fresh fascia lata autograft used clinically, on shoulder biomechanics in irreparable rotator cuff tendon tear.

Methods: Eight fresh-frozen cadaveric shoulders were tested by using a custom testing device. Subacromial peak contact pressure (pressure sensor), superior glenohumeral translation (three-dimensional digitizing system), and glenohumeral range of motion (goniometer) were compared under three conditions: (1) intact shoulder; (2) simulated irreparable rotator cuff (supraspinatus and infraspinatus) tear; and (3) SCR using fresh-frozen fascia lata graft. SCR was performed according to the technique for SCR using fascia lata autograft. The average graft thickness was 8.6 mm at the medial edge and 8.9 mm at the lateral edge.

Results: Compared with the intact condition, creation of the irreparable rotator cuff tear increased superior translation and subacromial peak contact pressure at 0° (P < 0.01) and 30° (P < 0.001) of glenohumeral abduction. SCR using fresh-frozen fascia lata graft decreased superior translation and subacromial peak contact pressure to the intact level (P < 0.01 for both). SCR using fresh-frozen fascia lata graft did not decrease internal (P = 0.15 to 0.99), external (P = 0.90 to 0.99), or total (P = 0.35 to 0.98) rotation at 0°, 30°, or 60° of glenohumeral abduction, compared with the irreparable supraspinatus and infraspinatus tendon tear condition.

Conclusion: For irreparable supraspinatus and infraspinatus tendon tear, SCR using 8 mm-thick fresh-frozen fascia lata graft restored superior glenohumeral stability to the intact level without any restriction of glenohumeral range of motion after surgery.

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背景:上关节囊重建术(SCR)是为恢复肩袖撕裂无法修复的肩关节的盂肱稳定性和功能而开发的。以前的生物力学研究调查了使用真皮移植或冻干筋膜同种异体移植进行 SCR 的效果。本研究的目的是探讨使用与临床上使用的新鲜筋膜自体移植物非常相似的新鲜冷冻筋膜移植对不可修复肩袖肌腱撕裂患者肩部生物力学的影响:方法:使用定制的测试装置对 8 具新鲜冷冻的尸体肩部进行测试。在三种条件下对肩峰下接触压力(压力传感器)、盂肱上平移(三维数字化系统)和盂肱运动范围(动态关节角度计)进行了比较:(1) 完整的肩部;(2) 模拟不可修复的肩袖(冈上和冈下)撕裂;(3) 使用鲜冻筋膜移植的 SCR。SCR按照使用自体筋膜进行SCR的技术进行。内侧边缘的平均移植厚度为 8.6 毫米,外侧边缘的平均移植厚度为 8.9 毫米:结果:与完好的情况相比,不可修复的肩袖撕裂增加了0°时的上平移和肩峰下接触压力(P 结论:对于不可修复的肩袖撕裂,上平移和肩峰下接触压力都增加了:对于无法修复的冈上和冈下肌腱撕裂,使用 8 毫米厚的新鲜冷冻筋膜移植进行 SCR,可将盂肱关节的稳定性恢复到完好水平,且术后盂肱关节的活动范围不会受到任何限制。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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