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Long Head of the Biceps Autograft performs biomechanically similar to Human Dermal Allograft for Superior Capsule Reconstruction after Rotator Cuff Tear

Published:November 14, 2022DOI:https://doi.org/10.1016/j.arthro.2022.10.023

      Purpose

      To provide a biomechanical comparison between human dermal (HD) allograft and long head of biceps tendon (LHBT) autograft with and without posterior side-to-side suturing for superior capsule reconstruction (SCR)

      Methods

      8 fresh-frozen cadaveric shoulder specimens were tested in 5 conditions: (1) intact, (2) complete supraspinatus tear, (3) LHBT, (4) LHBT with side-to-side suturing, (5) HD allograft with side-to-side suturing. Functional abduction force, superior translation of humeral head, translational range of motion, and rotational range of motion were tested at 0º, 30º, 60º, and 90º of abduction within each condition. Data was analyzed using analysis of variance with post-hoc Tukey testing for pairwise comparison, with a significance value set at 0.05.

      Results

      Functional abduction force in the LHBT, LHBT+ suture, and HD+ suture conditions was significantly increased compared to the supraspinatus tear condition at abduction angles of 30º (p=0.011, 0.001, and 0.017 respectively), 60º (p=0.004, 0.001, and 0.002 respectively), and 90º (p=0.013, 0.001, and 0.038 respectively). Additionally, superior translation of the humeral head in the LHBT, LHBT+ suture, and HD+ suture conditions was significantly decreased compared to the tear condition at abduction angles of 30º (p=0.03, 0.049, 0.03 respectively) and 60º (p=0.02, 0.04, 0.03 respectively). All 3 reconstructive techniques were statistically identical to the intact rotator cuff condition in regard to translational and rotational range of motion.

      Conclusions

      SCR with LHBT autograft without side-to-side suturing, LHBT with posterior side-to-side suturing, and HD allograft with posterior side-to-side suturing all equivalently restore functional abduction force and decrease superior translation of the humeral head after a complete supraspinatus tear.

      Clinical Relevance

      Superior capsule reconstruction with long head of the biceps tendon autograft and human dermal allograft both restore functional abduction force and decrease superior translation of the humeral head, while displaying no losses in the range of motion in a cadaveric model.
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