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A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear
Journal article   Peer reviewed

A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear

Teruhisa Mihata, Christopher N.H. Bui, Masaki Akeda, Matthew A. Cavagnaro, Michael Kuenzler, Alexander B. Peterson, Michelle H. McGarry, Yasuo Itami, Orr Limpisvasti, Masashi Neo, …
Journal of Shoulder and Elbow Surgery, Vol.26(12)
2017

Abstract

Aged Allografts Biomechanical Phenomena Cadaver Fascia Lata Female Humans Joint Capsule Male Middle Aged Movement Range of Motion, Articular Reconstructive Surgical Procedures Rotator Cuff Injuries Shoulder Joint Skin Transplantation Suture Techniques Article biomechanics comparative study fascia lata graft size human humeral head humerus intermethod comparison priority journal range of motion rotator cuff rupture shoulder surgery skin allograft superior capsule reconstruction suture technique aged allograft biomechanics cadaver fascia lata female joint capsule joint characteristics and functions male middle aged movement (physiology) pathophysiology procedures reconstructive surgery rotator cuff injury shoulder skin transplantation suture technique transplantation
Background Biomechanical and clinical success of the superior capsule reconstruction (SCR) using fascia lata (FL) grafts has been reported. In the United States, human dermal (HD) allograft has been used successfully for SCRs; however, the biomechanical characteristics have not been reported. Methods Eight cadaveric shoulders were tested in 5 conditions: (1) intact; (2) irreparable supraspinatus tear; (3) SCR using FL allograft with anterior and posterior suturing; (4) SCR using HD allograft with anterior and posterior suturing; and (5) SCR using HD allograft with posterior suturing. Rotational range of motion, superior translation, glenohumeral joint force, and subacromial contact were measured at 0°, 30°, and 60° of glenohumeral abduction in the scapular plane. Graft dimensions before and after testing were also recorded. Biomechanical parameters were compared using a repeated-measures analysis of variance with Tukey post hoc test, and graft dimensions were compared using a Student t-test (P < .05). Results Irreparable supraspinatus tear significantly increased superior translation, superior glenohumeral joint force, and subacromial contact pressure, which were completely restored with the SCR FL allografts. Both SCR HD allograft repairs partially restored superior translation and completely restored subacromial contact and superior glenohumeral joint force. The HD allografts significantly elongated by 15% during testing, whereas the FL allograft lengths were unchanged. Conclusions Single-layered HD SCR allografts partially restored superior glenohumeral stability, whereas FL allograft SCR completely restored the superior glenohumeral stability. This may be due to the greater flexibility of the HD allograft, and the SCR procedure used was developed on the basis of FL grafts. © 2017

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