The choice of the optimal graft for superior capsule reconstruction of the shoulder with massive rotator cuff tear.

Background. The hypothesis of the study was that knowledge about the mechanical properties of biological tissues will help surgeons to choose a transplant. Аim: to determine the optimal type of graft, based on the assessment of the mechanical properties of three types of grafts used for the superior capsule reconstruction of the shoulder joint with massive rotator cuff tear. Methods. In the experimental work, 3 types of biological tissues were studied: allografts fascia lata and dura mater, DX Reinforcement Matrix, Arthrex. The experiment was divided into two parts. In the first part, the mechanical strength at rupture of the samples was evaluated and compared, in the second for resistance to the applied vertical stitch. The type of tests performed included uniaxial stretching. Results. Fascia lata allograft has the maximum tensile strength, and the dura mater allograft has the minimum. All three materials showed a good value of elongation before fracture. The largest value of the maximum force during eruption was recorded for DX Reinforcement Matrix and was 33.5 N. The minimum value was recorded in the fascia lata allograft and is almost 10 N. Conclusion. Fascia lata allograft and DX Reinforcement Matrix, Arthrex have optimal mechanical characteristics and can be recommended as grafts for the superior capsule reconstruction of the shoulder joint with massive rotator cuff tear

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A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2017.07.019 ◽

2017 ◽

Vol 26 (12) ◽

pp. 2158-2166 ◽

Cited By ~ 59

Author(s):

Teruhisa Mihata ◽

Christopher N.H. Bui ◽

Masaki Akeda ◽

Matthew A. Cavagnaro ◽

Michael Kuenzler ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Fascia Lata ◽

Cadaveric Study ◽

Cuff Tear ◽

Superior Capsule Reconstruction ◽

Irreparable Rotator Cuff Tear

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Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

10.21203/rs.3.rs-23765/v1 ◽

2020 ◽

Author(s):

Chen-Heng Hsu ◽

Chih-Hao Chiu ◽

Chun-Jui Weng ◽

Kuo-Yau Hsu ◽

Yi-Sheng Chan ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Biceps Tendon ◽

Fascia Lata ◽

Cuff Tear ◽

Novel Technique ◽

Superior Capsule Reconstruction ◽

Fascia Graft ◽

Irreparable Rotator Cuff Tear

Abstract Background: While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft.Methods: Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged.Results: Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more than one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients.Conclusions: Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

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Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

10.21203/rs.3.rs-32772/v1 ◽

2020 ◽

Author(s):

Chen-Heng Hsu ◽

Chih-Hao Chiu ◽

Chun-Jui Weng ◽

Kuo-Yau Hsu ◽

Yi-Sheng Chan ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Biceps Tendon ◽

Fascia Lata ◽

Cuff Tear ◽

Novel Technique ◽

Superior Capsule Reconstruction ◽

Fascia Graft ◽

Irreparable Rotator Cuff Tear

Abstract Background While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft. Methods Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged. Results Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients. Conclusions Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

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