Abstract
Postoperative graft tear is correlated with poor clinical outcome after superior capsule reconstruction (SCR) for irreparable rotator cuff tears. The objective of this study was to investigate the optimal tension of the SuturePatch, which has been developed to reinforce SCR.
Eight fresh-frozen cadaveric shoulders were tested by using a custom shoulder-testing system. Superior glenohumeral translation, subacromial peak contact pressure, and glenohumeral range of motion (ROM) were compared among 4 conditions: 1) intact; 2) irreparable supraspinatus and infraspinatus tears; 3) SCR using a thin fascia lata graft and SuturePatch augmentation performed at 20° glenohumeral abduction; and 4) SCR using the same graft with SuturePatch augmentation performed at 30° glenohumeral abduction.
Increased superior glenohumeral translation and subacromial peak contact pressure after creation of an irreparable supraspinatus and infraspinatus tendon tear significantly decreased after SCR with SuturePatch augmentation performed at both 20° and 30° glenohumeral abduction. Superior glenohumeral translation and subacromial peak contact pressure did not differ between 20° and 30° glenohumeral abductions. Internal rotation (P = 0.39 to 0.99), external rotation (P = 0.61 to 0.99), or total rotational range of motion (P = 0.51 to 0.99) were comparable between the irreparable supraspinatus and infraspinatus tendon tear condition and SCR with SuturePatch augmentation at both 20° and 30° glenohumeral abduction.
SCR with SuturePatch augmentation restored superior glenohumeral stability and maintained glenohumeral range of motion. When the SuturePatch is used to augment the graft of SCR, 30° or 45° of shoulder abduction (equal to 20° or 30° of glenohumeral abduction) may provide the optimal tension for graft attachment to the glenoid medially and greater tuberosity laterally.