A biomechanical study to optimize superior capsular reconstruction operative technique

© 2023 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 8(2024), 3 vom: 15. Mai, Seite 451-458
1. Verfasser: Dasari, Suhas P (VerfasserIn)
Weitere Verfasser: Vadhera, Amar S, Menendez, Mariano E, Khan, Zeeshan A, Inoue, Nozomu, Shewman, Elizabeth, Waterman, Brian R, Garrigues, Grant E, Cole, Brian J, Verma, Nikhil N
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Biomechanics Bone mineral density Glenoid neck Glenoid rim Rotator cuff tear Shoulder Superior capsular reconstruction Suture anchor fixation
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245 1 2 |a A biomechanical study to optimize superior capsular reconstruction operative technique 
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520 |a Background: The goals of this study were to optimize superior capsular reconstruction by assessing the relative fixation strength of 4 suture anchors; evaluating 3 glenoid neck locations for fixation strength and bone mineral density (BMD); determining if there is a correlation between BMD and fixation strength; and determining which portal sites have optimal access to the posterosuperior and anterosuperior glenoid neck for anchor placement 
520 |a Methods: Twenty cadaveric specimens were randomized into 4 groups: all-suture anchor (FiberTak), conventional 3.0-mm knotless suture anchor (SutureTak), 3.9-mm knotless PEEK (polyetheretherketone) Corkscrew anchor, and 4.5-mm Bio-Corkscrew anchor. Each specimen was prepared with 3 anchors into the glenoid: an anterosuperior anchor, superior anchor, and posterosuperior anchor. All anchors were inserted into the superior glenoid neck 5 mm from the glenoid rim. A materials testing system performed cyclic testing (250 cycles) followed by load-to-failure testing at 12.5 mm/s. Cyclic elongation, first cycle excursion, maximum load, and stiffness were recorded. Using custom software, BMD was calculated at each anchor location. This software was also used to assess access to the posterosuperior and anterosuperior glenoid neck from standard arthroscopic portal positions 
520 |a Results: There was no significant difference in cyclic elongation (P = .546), first cycle excursion (P = .476), maximum load (P = .817), or stiffness (P = .309) among glenoid anchor positions. Cyclic elongation was significantly longer in the PEEK Corkscrew group relative to the other implants (P ≤ .002). First cycle excursion was significantly greater in the FiberTak group relative to all other implants (P ≤ .008). For load-to-failure testing, the Bio-Corkscrew group achieved the highest maximum load (P ≤ .001). No other differences in cyclic or failure testing were observed between the groups. No differences in stiffness testing were observed (P = .133). The superior glenoid rim had the greatest BMD (P = .003), but there was no correlation between BMD and cyclic/load outcomes. The posterior portal (80% of specimens) and the anterior portal (60% of specimens) demonstrated the best access to the posterosuperior and anterosuperior glenoid neck, respectively 
520 |a Conclusion: The 4.5-mm Bio-Corkscrew anchor provided the most robust fixation to the glenoid during superior capsular reconstruction as it demonstrated the strongest maximum load, had minimal elongation, had minimal first cycle excursion, and did not fail during cyclic testing. The superior glenoid neck had the highest BMD; however, there was no correlation between BMD or glenoid anchor location and biomechanical outcomes. The posterior portal and anterior portal provided optimal access to the posterosuperior glenoid neck and anterosuperior glenoid neck, respectively 
650 4 |a Journal Article 
650 4 |a Biomechanics 
650 4 |a Bone mineral density 
650 4 |a Glenoid neck 
650 4 |a Glenoid rim 
650 4 |a Rotator cuff tear 
650 4 |a Shoulder 
650 4 |a Superior capsular reconstruction 
650 4 |a Suture anchor fixation 
700 1 |a Vadhera, Amar S  |e verfasserin  |4 aut 
700 1 |a Menendez, Mariano E  |e verfasserin  |4 aut 
700 1 |a Khan, Zeeshan A  |e verfasserin  |4 aut 
700 1 |a Inoue, Nozomu  |e verfasserin  |4 aut 
700 1 |a Shewman, Elizabeth  |e verfasserin  |4 aut 
700 1 |a Waterman, Brian R  |e verfasserin  |4 aut 
700 1 |a Garrigues, Grant E  |e verfasserin  |4 aut 
700 1 |a Cole, Brian J  |e verfasserin  |4 aut 
700 1 |a Verma, Nikhil N  |e verfasserin  |4 aut 
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