Purpose
The purpose of the current study was to create a dynamic cadaveric shoulder model
to determine the effect of graft fixation angle on shoulder biomechanics following
SCR and to assess which commonly used fixation angle (30° vs 45° of abduction) results
in superior glenohumeral biomechanics.
Methods
Twelve fresh-frozen cadaveric shoulders were evaluated using a dynamic shoulder testing
system. Humeral head translation, subacromial and glenohumeral contact pressures were
compared among 4 conditions: 1) Intact, 2) Irreparable supra- and infraspinatus tendon
tear, 3) SCR using acellular dermal allograft (ADA) fixation at 30° of abduction,
and 4) SCR with ADA fixation at 45° of abduction.
Results
SCR at both 30° (0.287 mm, CI: −0.480 - 1.05 mm; P < .0001) and 45° (0.528 mm, CI: −0.239-1.305 mm; P = .0006) significantly decreased superior translation compared to the irreparably
torn state. No significant changes in subacromial peak contact pressure were observed
between any states. The average glenohumeral contact pressure increased significantly
following creation of an irreparable RCT (373 kPa, CI: 304-443 vs 283 kPa, CI 214-352;
P = .0147). The SCR performed at 45° (295 kPa, CI: 226-365, P = .0394) of abduction significantly decreased the average glenohumeral contact pressure
compared to the RCT state. There was no statistically significant difference between
the average glenohumeral contact pressure of the intact state and SCR at 30° and 45°.
Conclusion
SCR improved the superior stability of the glenohumeral joint when the graft was secured
at 30° or 45° of glenohumeral abduction. Fixation at 45° of glenohumeral abduction
provided more stability than did fixation at 30°.
Clinical Relevance
Grafts attached at 45° of glenohumeral abduction biomechanically restore the glenohumeral
stability after SCR using ADA better than fixation at 30° of glenohumeral abduction.
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Article info
Publication history
Published online: November 04, 2022
Accepted:
October 20,
2022
Received:
December 3,
2021
Footnotes
See commentary on page 931
The authors report the following potential conflicts of interest or sources of funding: P.J.M. reports grants, personal fees and other from Arthrex Inc, personal fees from Springer Publishing, personal fees from Medbridge, stock options from VuMedi, part owner of ProofPoint Biologics, research support from Steadman Philippon Research Institute, institutional funding from Smith & Nephew, Siemens, and Össur, outside the submitted work. B.A. reports other from Steadman Philippon Research Institute and fellowship support from Arthrex, Inc, outside the submitted work. H.W.S. reports employment from Steadman Philippon Research Institute, outside the submitted work. L.L. reports employment from Steadman Philippon Research Institute, outside the submitted work. G.J.D. reports employment from Steadman Philippon Research Institute, outside the submitted work. J.J.K. reports employment from Steadman Philippon Research Institute, outside the submitted work. Z.S.A. reports other from Steadman Philippon Research Institute, outside the submitted work. N.A. reports employment from Steadman Philippon Research Institute, outside the submitted work. S.I.R. reports employment from Steadman Philippon Research Institute, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
