A biomechanical evaluation of three surgical techniques for subscapularis repair.
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.
Van den Berghe
Gregory R
GR
Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA.
Nguyen
Bao
B
Patil
Shantanu
S
D'Lima
Darryl D
DD
Mahar
Andrew
A
Pedowitz
Robert
R
Hoenecke
Heinz R
HR
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*