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Double-Row Capsulolabral Repair Increases Load to Failure and Decreases Excessive Motion
Journal article   Peer reviewed

Double-Row Capsulolabral Repair Increases Load to Failure and Decreases Excessive Motion

Lucas S. McDonald, Matthew Thompson, David W. Altchek, Michelle H. McGarry, Thay Q. Lee, Vanna J. Rocchi and Joshua S. Dines
Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol.32(11)
2016

Abstract

Adult Aged Biomechanical Phenomena Cadaver Humans Middle Aged Range of Motion, Articular Rotation Shoulder Joint Suture Anchors Suture Techniques Young Adult adult aged Article biomechanics cadaver controlled study double row capsulolabral repair human human tissue humeral head intermethod comparison joint mobility load to failure testing musculoskeletal system examination range of motion recurrent shoulder dislocation rigidity shoulder surgery single row capsulolabral repair surgical technique suture anchor biomechanics joint characteristics and functions middle aged rotation shoulder surgery suture anchor suture technique young adult
Purpose Using a cadaver shoulder instability model and load-testing device, we compared biomechanical characteristics of double-row and single-row capsulolabral repairs. We hypothesized a greater reduction in glenohumeral motion and translation and a higher load to failure in a mattress double-row capsulolabral repair than in a single-row repair. Methods In 6 matched pairs of cadaveric shoulders, a capsulolabral injury was created. One shoulder was repaired with a single-row technique, and the other with a double-row mattress technique. Rotational range of motion, anterior-inferior translation, and humeral head kinematics were measured. Load-to-failure testing measured stiffness, yield load, deformation at yield load, energy absorbed at yield load, load to failure, deformation at ultimate load, and energy absorbed at ultimate load. Results Double-row repair significantly decreased external rotation and total range of motion compared with single-row repair. Both repairs decreased anterior-inferior translation compared with the capsulolabral-injured condition, however, no differences existed between repair types. Yield load in the single-row group was 171.3 ± 110.1 N, and in the double-row group it was 216.1 ± 83.1 N (P =.02). Ultimate load to failure in the single-row group was 224.5 ± 121.0 N, and in the double-row group it was 373.9 ± 172.0 N (P =.05). Energy absorbed at ultimate load in the single-row group was 1,745.4 ± 1,462.9 N-mm, and in the double-row group it was 4,649.8 ± 1,930.8 N-mm (P =.02). Conclusions In cases of capsulolabral disruption, double-row repair techniques may result in decreased shoulder rotational range of motion and improved load-to-failure characteristics. Clinical Relevance In cases of capsulolabral disruption, repair techniques with double-row mattress repair may provide more secure fixation. Double-row capsulolabral repair decreases shoulder motion and increases load to failure, yield load, and energy absorbed at yield load more than single-row repair. © 2016

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