1
|
Baek CH, Kim BT, Kim JG, Kim SJ. Clinical results of arthroscopically-assisted lower trapezius transfer using fascia lata autograft for posterior superior irreparable rotator cuff tear. J Orthop 2024; 52:78-84. [PMID: 38435318 PMCID: PMC10904162 DOI: 10.1016/j.jor.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
Background Different interpositional grafts have been proposed to connect between the lower trapezius tendon (LTT) to the humerus during LTT transfer. While studies often mention the successful use of Achilles tendon allograft, there is currently no literature reporting the clinical outcomes of utilizing fascia lata autograft (FLA) in LTT transfer. Therefore, the current study aims to evaluate the clinical and radiologic results of LTT using FLA for posterior superior irreparable rotator cuff tears (PSIRCTs) without arthritis. Patient and methods The present study constitutes a retrospective case series involving 22 patients, with a mean follow-up of 35.9 ± 15.9 months. Pain levels were gauged using the Visual Analog Scale (VAS), while shoulder function was comprehensively assessed through the Constant and ASES (American Shoulder and Elbow Society) scores. The evaluation of shoulder activities in daily living employed the ADLER (Activities of Daily Living Requiring Active External Rotation) score. Active ROM (Range of Motion) of all directions were obtained, radiologic assessments included key parameters such as AHD (Acromion Humeral Distance) and the Hamada grade. Finally, the integrity of the transferred LTT was evaluated, and a subgroup analysis was undertaken based on Tm trophicity. Results By the final follow-up period, VAS, Constant, ASES, and ALDER demonstrated significant improvement. Active ROM significantly improved in (FE) forward elevation to 155° ± 29°, abduction (Abd) to 140° ± 32°, external rotation (ER) at 90° Abd to 68° ± 19°, and ER at the side to 39° ± 17°. AHD and Hamada grade showed no significant arthritic progression. Tm hypertrophy group experienced superior improvements in ER compared to that of the non-hypertrophy group. Complications included re-tear (n = 2), infection (n = 1) and donor-site morbidity (n = 1). Conclusion The study highlighted promising clinical outcomes of LTT transfer using FLA, with no significant complications. Along with Achilles tendon allograft, FLA can be a safe and viable alternative interpositional graft choice.
Collapse
Affiliation(s)
- Chang Hee Baek
- Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, 59709, Republic of Korea
| | - Bo Taek Kim
- Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, 59709, Republic of Korea
| | - Jung Gon Kim
- Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, 59709, Republic of Korea
| | - Seung Jin Kim
- Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, 59709, Republic of Korea
| |
Collapse
|
2
|
Guizzi A, Collin P, Zbinden J, Hurtado JA, Amiri A, Lädermann A. Calcaneum-Achilles Tendon Allograft for Massive Posterosuperior Rotator Cuff Lesion With Bony Deficiency. Arthrosc Tech 2024; 13:102919. [PMID: 38690347 PMCID: PMC11056741 DOI: 10.1016/j.eats.2024.102919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/10/2023] [Indexed: 05/02/2024] Open
Abstract
Dealing with massive and irreparable rotator cuff tears presents intricate challenges. Concerning elder patients, either conservative management or reverse shoulder arthroplasty could be the most appropriate treatment. On the other hand, in younger patients, there is a wide spectrum of solutions, most of them being under evaluation and not completely validated. The complexity increases when a greater tuberosity avulsion occurs at the same time. Regardless of whether surgical fixation is performed, there is a risk for bone resorption, which would result in the posterosuperior cuff's insertion spot loss. In this case, the surgeon is expected to simultaneously manage the bone loss and the tendon tear. The Calcaneum-Achilles Tendon Allograft (CalATA) therefore appears to play an interesting role due to its solid bone-tendon structure. This Technical Note aims to present the CalATA technique, which consists in both tendon and bone deficiency restoration in massive rotator cuff tears with greater tuberosity resorption.
Collapse
Affiliation(s)
- Alberto Guizzi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Philippe Collin
- CHP Saint-Gregoire, Saint-Grégoire, France
- Clinique Victor Hugo, Paris, France
- American Hospital of Paris, Neuilly-sur-Seine, France
| | - Jeanni Zbinden
- Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
| | - Juan Arturo Hurtado
- Clínica San Pablo Surco, Lima, Perú
- Clínica San Gabriel, Lima, Perú
- Clínica Providencia, Lima, Perú
| | - Arash Amiri
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
3
|
Rougereau G, Chatelain L, Zadegan F, Conso C. Estimation of the carbon footprint of arthroscopic rotator cuff repairs in France. Orthop Traumatol Surg Res 2024; 110:103755. [PMID: 37949395 DOI: 10.1016/j.otsr.2023.103755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 11/12/2023]
Abstract
AIM The main objective of this study was to estimate the carbon impact of arthroscopic rotator cuff repairs in France. The secondary objective was to assess the effectiveness of the following measures in reducing the carbon footprint associated with this technique: outpatient treatment, arthroscopic water filtration, surgery under locoregional anesthesia. HYPOTHESIS The hypothesis was that the carbon footprint could be significantly improved with the implementation of these three procedures. METHODS A continuous series of 26 patients who underwent surgery for a rotator cuff tear involving only one tendon between November 2020 and April 2021 were included. The evaluation protocol consisted of three parts: 1/ use of volatile anesthetic agents; 2/ electrical consumption linked to the procedure; 3/ emissions related to patient and staff travel, delivery of implants and waste management. Another series of 26 patients operated between November 2018 and April 2019 who had none of these three factors were matched. RESULTS The carbon impact of arthroscopic repair of the rotator cuff was estimated at 334.61±18.82kgCO2eq. The implementation of the three methods for improvement made it possible to significantly reduce emissions by 40.9±1.71kgCO2eq (12.2%) (p<0.001). CONCLUSION Performing surgery under locoregional anesthesia, on an outpatient basis with water purification, reduces the carbon impact of arthroscopic rotator cuff repair by more than 12%. LEVEL OF EVIDENCE III, retrospective case control.
Collapse
Affiliation(s)
- Grégoire Rougereau
- Service de chirurgie orthopédique, Institut Mutualiste Montsouris, Paris, France; Service de chirurgie orthopédique et traumatologique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
| | - Léonard Chatelain
- Service de chirurgie orthopédique, Institut Mutualiste Montsouris, Paris, France
| | - Frédéric Zadegan
- Service de chirurgie orthopédique, Institut Mutualiste Montsouris, Paris, France
| | - Christel Conso
- Service de chirurgie orthopédique, Institut Mutualiste Montsouris, Paris, France
| |
Collapse
|
4
|
von Knoch M, Hoffmann DB, Baums MH. Which Factors Are Associated With Rerupture After Superior Capsular Reconstruction of the Shoulder With Autologous Long Biceps Tendon? - A Systematic Review. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2023. [PMID: 37967830 DOI: 10.1055/a-2195-0790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Based on a systematic review, the present work analyses factors associated with the rerupture rate or non-healing after superior capsular reconstruction with autologous long biceps tendon in the reconstruction of the rotator cuff of the shoulder.A systematic review of the U.S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was conducted in September 2021 using the PRISMA checklist. Articles were identified and analysed that contained data on the rerupture rate after superior capsular reconstruction with autologous long biceps tendon in reconstruction of the rotator cuff of the shoulder. The aim was to identify factors associated with rerupture or non-healing. The risk of bias was determined using the Newcastle-Ottawa scale.Primarily 86 hits could be generated. Seven articles from 2020 and 2021 met the inclusion criteria and were further analysed in terms of content. The evidence level was III to IV. Follow-up was between 12 (minimum) and 24 to 48 months. The risk of bias was not low. Factors that may be associated with rerupture or non-healing are diabetes mellitus and high-grade fatty degeneration of the subscapularis, infraspinatus, or teres minor as preoperative factors. Age, percent footprint coverage, tear size, symptom duration, number of bundles, acromioplasty performed, and tear configuration were not significant factors. Gender, degree of fatty degeneration of the supraspinatus and lesions of the subscapularis tendon were rated differently.According to the literature, but still currently with short-term observation periods, superior capsular reconstruction with an autologous long biceps tendon is another treatment option in the case of massive tears and elderly patients, if there is no high-grade fatty degeneration of the subscapularis, infraspinatus or teres minor. Diabetes mellitus has an unfavorable prognosis. Additional acromioplasty has so far not been associated with better outcomes.
Collapse
Affiliation(s)
- Marius von Knoch
- Schulterchirurgie, Kreiskrankenhaus Osterholz, Osterholz-Scharmbeck, Deutschland
- Schulterchirurgie, AMEOS Klinikum Seepark Geestland, Geestland, Deutschland
| | - Daniel B Hoffmann
- Klinik für Unfallchirurgie, Orthopädie und plastische Chirurgie, Universitätsmedizin Göttingen, Gottingen, Deutschland
| | - Mike H Baums
- Fachbereich Orthopädie, Unfallchirurgie und Sporttraumatologie, Katholisches Klinikum Ruhrgebiet Nord GmbH, Dorsten, Deutschland
| |
Collapse
|
5
|
Besnard M, Favard L, Benhenneda R. Arthroscopic advancement of the supraspinatus muscle and tendon for posterosuperior massive rotator cuff tears. Orthop Traumatol Surg Res 2023; 109:103536. [PMID: 36574836 DOI: 10.1016/j.otsr.2022.103536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/20/2022] [Accepted: 09/07/2022] [Indexed: 12/25/2022]
Abstract
The tension-free repair of retracted supraspinatus tears with the open muscle and tendon advancement technique first described by Debeyre in 1965 gave satisfactory clinical results. The purpose of this anatomical study was to test the feasibility of an arthroscopic supraspinatus advancement technique. A total of 10 cadaveric shoulders were operated. We assessed the feasibility, measured the slide distance, and recorded the position of the suprascapular nerve (SSN) for each shoulder. Reattachment of the tendon to its native footprint was achieved in all cases. The mean slide distance was 38.8 mm ± 3.6 (33-44). The SSN was released and tension-free in all shoulders. Arthroscopic advancement of the supraspinatus muscle and tendon enables complete rotator cuff repair in irreparable retracted posterosuperior tears and is a noteworthy alternative to the other techniques. Level of Evidence: IV.
Collapse
Affiliation(s)
- Marion Besnard
- Centre hospitalier inter-communal Amboise-Château-Renault, hôpital Robert-Debré, rue des Ursulines, BP 329, 37403 Amboise cedex, France
| | - Luc Favard
- Service de chirurgie orthopédique, centre hospitalier universitaire de Tours, université François-Rabelais de Tours, PRES centre-Val de Loire université, Tours, France; Faculté de médecine, université de Tours, 10, boulevard Tonnellé, 37000 Tours, France
| | - Rayane Benhenneda
- Service de chirurgie orthopédique, centre hospitalier universitaire de Tours, université François-Rabelais de Tours, PRES centre-Val de Loire université, Tours, France; Faculté de médecine, université de Tours, 10, boulevard Tonnellé, 37000 Tours, France.
| |
Collapse
|
6
|
Martinho T, Zbinden J, Ono Y, Amiri A, Collin P, Lädermann A. Long Head of the Biceps Pediculated Autograft Augmentation of Arthroscopic Subscapularis Repair. Arthrosc Tech 2023; 12:e1391-e1398. [PMID: 37654870 PMCID: PMC10466290 DOI: 10.1016/j.eats.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/12/2023] [Indexed: 09/02/2023] Open
Abstract
Subscapularis (SSc) repairs are not free of failure and continues to pose a challenging problem. Although various biological and structural augmentation methods are available for the posterosuperior rotator cuff, few options have been explored for the anterior one. In the Technical Note, we describe an all-arthroscopic technique in which we use the long head of the biceps tendon (LHBT) as a pediculated autograft to reinforce an SSc repair. After SSc repair and LHBT tenodesis, the intra-articular portion of the LHBT is placed on the upper part of the SSc tendon at the rotator interval. Repurposing the otherwise-discarded tendon brings several biological and mechanical advantages at a lower cost without donor-site morbidity.
Collapse
Affiliation(s)
- Tiago Martinho
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jeanni Zbinden
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
| | - Yohei Ono
- Hokkaido Shoulder Clinic, Hokkaido, Japan
| | - Arash Amiri
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
| | | | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
7
|
Lädermann A. Editorial Commentary: Shoulder Arthroscopic Dynamic Anterior Stabilization Is Effective for Anteroinferior Shoulder Instability With Limited Anterior Bone Loss. Arthroscopy 2023; 39:1628-1629. [PMID: 37286282 DOI: 10.1016/j.arthro.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 06/09/2023]
Abstract
Shoulder dynamic anterior stabilization (DAS) is an efficient and well-established glenohumeral stabilization technique, offering an arthroscopic alternative to Latarjet and glenoid reconstruction with distal tibial allograft or the iliac crest autograft. DAS is essentially an augmented Bankart procedure and can be performed using transfer of either the long head of the biceps tendon or the conjoined tendon. Both result in similar and acceptable rates of recurrences, complications, return to sport, and subjective shoulder function. However, the effectiveness of Bankart repair on shoulder stability decreases significantly over time, so long-term follow-up evaluations of DAS are required. The best indication for DAS may be anteroinferior shoulder instability with limited anterior bone loss.
Collapse
|
8
|
Krishnan P, Maassen N, Lee C, Baker H, Koh J, Amirouche F, Athiviraham A. Long Head of the Biceps Autograft Performs Biomechanically Similar to Human Dermal Allograft for Superior Capsule Reconstruction After Rotator Cuff Tear. Arthroscopy 2023; 39:706-715. [PMID: 36395965 DOI: 10.1016/j.arthro.2022.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
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. METHODS Eight 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, and (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 0°, 30°, 60°, and 90° of abduction within each condition. Data were analyzed using analysis of variance with post-hoc Tukey testing for pairwise comparison, with a significance value set at .05. RESULTS Functional abduction force in the LHBT, LHBT + suture, and HD + suture conditions was significantly increased compared with the supraspinatus tear condition at abduction angles of 30° (P = .011, .001, and .017, respectively), 60° (P = .004, .001, and .002, respectively), and 90° (P = .013, .001, and .038, respectively). In addition, superior translation of the humeral head in the LHBT, LHBT + suture, and HD + suture conditions was significantly decreased compared with the tear condition at abduction angles of 30° (P = .03, .049, .03, respectively) and 60° (P = .02, .04, .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 Superior capsule reconstruction 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.
Collapse
Affiliation(s)
- Pranav Krishnan
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, U.S.A
| | - Nicholas Maassen
- Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, U.S.A
| | - Cody Lee
- Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, U.S.A
| | - Hayden Baker
- Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, U.S.A
| | - Jason Koh
- Department of Orthopaedic Surgery, Northshore University Health System, Chicago, Illinois, U.S.A
| | - Farid Amirouche
- Department of Orthopaedic Surgery, Northshore University Health System, Chicago, Illinois, U.S.A.; Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, U.S.A
| | - Aravind Athiviraham
- Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, U.S.A..
| |
Collapse
|
9
|
Lädermann A. Editorial Commentary: The Long Head of the Biceps Tendon Is Useful for Shoulder Reconstruction Including Glenohumeral Stabilization: From Biceps Killers to Biceps Users. Arthroscopy 2023; 39:202-203. [PMID: 36603990 DOI: 10.1016/j.arthro.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 01/04/2023]
Abstract
Historically, it was believed that the shoulder long head of the biceps tendon (LHBT) was a pain generator and had to be routinely sacrificed. Recently, it has become apparent that the LHBT is useful as an autograft for various types of surgical reconstruction, including superior capsular reconstruction for irreparable rotator cuff tears, and augmentation for poor soft-tissue quality during rotator cuff repair or shoulder arthroplasty. In cases of shoulder instability, the biceps can reinforce the capsule or reconstruct a missing labrum for glenohumeral stabilization. Dynamic anterior stabilization transfers the LHBT through the subscapularis to the anterior glenoid margin, creating "sling" and "hammock" effects. Various labral augmentation techniques also have been described. In a paradigm shift, shoulder surgeons may become LHBT users instead of LHBT "killers."
Collapse
|
10
|
Superior capsular reconstruction using hybrid graft for irreparable massive rotator cuff tear. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07321-2. [PMID: 36709237 DOI: 10.1007/s00167-023-07321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 01/13/2023] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the clinical and radiological outcomes of arthroscopic superior capsular reconstruction (SCR) using hybrid grafts composed of tensor fascia lata autografts and human dermal allografts. METHODS This study included 30 patients with chronic irreparable posterosuperior rotator cuff tears (RCTs) who underwent arthroscopic SCR using a hybrid graft composed of tensor fascia lata autograft and human dermal allograft. Clinical outcomes were evaluated using the pain visual analogue scale score, shoulder range of motion, American Shoulder and Elbow Surgeons score, constant score, University of California-Los Angeles score, and simple shoulder test score preoperatively and at least 2 years after surgery. Radiographic analysis included the Hamada classification grade, acromiohumeral distance (AHD), and graft integrity at 2 years after surgery. RESULTS All patients exhibited significant clinical improvement in all functional outcome measurements, except external rotation (all P < 0.05). The number of patients who exhibited pseudoparalysis decreased from 7 (23.3%) to 2 (6.7%) postoperatively. Complications were not observed. Radiologically, the mean postoperative AHD increased significantly from 6.9 ± 1.6 cm to 8.8 ± 2.1 cm at 2 years postoperatively (P < 0.001). Twenty five out of the 30 (83.3%) patients showed successful graft healing, and all healing failures occurred on the humeral side. The differences between the healed-graft and failed-graft groups were significantly lower graft thickness (P = 0.001) and smaller AHD (P < 0.001) in the failed-graft group. Every functional outcome scores were not statistically different between healed-graft and failed-graft groups. CONCLUSIONS An arthroscopic SCR technique using a hybrid graft consisting of a tensor fascia lata autograft and human dermal allograft showed satisfactory clinical outcomes in patients with irreparable RCTs. LEVEL OF EVIDENCE IV.
Collapse
|
11
|
Innovations in the Realm of Shoulder Arthroplasty. J Clin Med 2022; 12:jcm12010237. [PMID: 36615036 PMCID: PMC9821058 DOI: 10.3390/jcm12010237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
Most of the surgeries regarding the shoulder were established over a century ago [...].
Collapse
|
12
|
Lädermann A, Rashid M. Superior Capsular Reconstruction-Technical Marvel or Fading Fashion? Arthroscopy 2022; 38:2954-2956. [PMID: 36344054 DOI: 10.1016/j.arthro.2022.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Faculty of Medicine, University of Geneva, Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Mustafa Rashid
- Wrightington Hospital, Wigan, Lancashire, United Kingdom
| |
Collapse
|
13
|
Arthroscopic Superior Capsular Reconstruction with Achilles Tendon Allograft for Massive and Revision Rotator Cuff Tears. Arthrosc Tech 2022; 11:e263-e271. [PMID: 35155122 PMCID: PMC8821895 DOI: 10.1016/j.eats.2021.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/21/2021] [Indexed: 02/03/2023] Open
Abstract
Massive irreparable rotator cuff tears (RCT) in younger and active patients remain a significant clinical challenge to orthopaedic surgeons. Superior capsular reconstruction (SCR) has been presented as a way to restore the restraining effect of the superior joint capsule and the balanced force couples necessary for dynamic shoulder function; furthermore, it does not exclude future treatment options. The purpose of this article is to show a technical modification of the SCR in massive and revision RCT using Achilles tendon allograft as an effective static restraint to prevent superior migration of the humeral head due to its thickness and robustness, and performing a side-to-side repair on the greater tuberosity between the graft and the residual infraspinatus tendon to completely restore the superior stability of the shoulder joint.
Collapse
|