Purpose
To examine the biomechanical differences between labral repair with transferred conjoined
tendon and transferred long head of the biceps tendon (LHBT) for anterior shoulder
instability with 20% bone loss.
Methods
Twelve cadaveric shoulders were tested in sequent 5 conditions: intact, 20% glenoid
defect, Bankart repair, Bankart repair with transferred conjoined tendon (dynamic
conjoined tendon sling, DCS), and with transferred LHBT (dynamic LHBT sling, DLS)
at 60° of glenohumeral abduction and 60° of external rotation. The physiological glenohumeral
joint load was created by forces applied to the rotator cuff, conjoined tendon, and
LHBT. The glenohumeral compression force and range of motion were recorded before
anteroinferior force application. The anterior, inferior, and total translations were
measured with 20, 30, 40, and 50 N of anteroinferior force, respectively.
Results
Anteroinferior glenoid defect led to significant increase of humerus translation and
decrease of glenohumeral compression force. DLS provided better resistance effect
in both anterior–posterior and superior–inferior directions than DCS under high loading
condition (40 N, P =.03; 50 N, P <.01). Both DCS and DLS procedures could further restore glenohumeral compression
force with Bankart repair (Bankart repair: 32.1 ± 4.0 N; DCS: 36.7 ± 3.2 N, P < .01; DLS: 35.8 ± 3.6 N, P =.03). No range of motion restrictions were observed relative to the normal shoulder.
Conclusions
Both the DLS and DCS techniques could reduce the anterior–inferior translation and
partially restore the glenohumeral stability in anterior shoulder instability with
20% anteroinferior glenoid defect compared with Bankart repair. Under greater loading
conditions, DLS provides better stability than DCS.
Clinical Relevance
Shoulder stability can be restored by DLS and DCS with low load. With greater shoulder
stability requirements, DLS might be a better option than DCS for anterior shoulder
instability with 20% bone loss.
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Article info
Publication history
Published online: March 29, 2022
Accepted:
March 7,
2022
Received:
October 30,
2021
Footnotes
See commentary on page 2636
The authors report the following potential conflicts of interest or sources of funding: This work was supported by National Natural Science Foundation of China (grant nos. 27 81902186, 81671920, 31972923, 81871753, 81772341), National Key Research and Development Program of China (grant nos. 2018YFC1106200, 2018YFC1106201, 2018YFC1106202), and Technology Support Project of Science and Technology Commission of Shanghai Municipality of China (grant nos. 19441901700, 19441901701, 19441901702, 19441902500, 18441902800). ICMJE author disclosure forms are available for this article online, as supplementary material.
Yuhao Kang, Ph.D., and Liren Wang, Ph.D., contributed equally to this article.
Data sharing: Original data from this article can be properly requested through e-mail.
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© 2022 by the Arthroscopy Association of North America
