title: A biomechanical evaluation of three surgical techniques for subscapularis repair.
abstract: This study was designed to determine which subscapularis repair method performs best under fatigue loading. Fresh-frozen human cadaveric shoulders were used. A standard circumferential release was performed, including a rotator interval release and separation of the subscapularis from the anterior and inferior capsules. One of 3 methods was used to repair the subscapularis tendon: tendon-to-tendon, tendon-to-bone, or bone-to-bone using a buttress plate. The shoulder was mounted on a fatigue-testing machine, and the medial end of the subscapularis tendon was attached to a soft-tissue clamp. We initially tested each specimen for fatigue at 150 N for 500 cycles, then at 300 N for 2500 cycles. The failure rate of bone-to-bone and tendon-to-tendon repairs was significantly better than that of the tendon-to-bone repair. The bone-to-bone repair exhibited the best combination of repair strength and restoration of subscapularis length.
authors.affiliation: Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Van den Berghe
authors.forename: Bao
authors.initials: B
authors.lastname: Nguyen
authors.forename: Shantanu
authors.initials: S
authors.lastname: Patil
authors.forename: Darryl D
authors.initials: DD
authors.lastname: D'Lima
authors.forename: Andrew
authors.initials: A
authors.lastname: Mahar
authors.forename: Robert
authors.initials: R
authors.lastname: Pedowitz
authors.forename: Heinz R
authors.initials: HR
authors.lastname: Hoenecke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012785:Shoulder Joint / Q000601:surgery*; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*