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Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation for Subscapularis Peel Repair
BACKGROUND: Failure of a subscapularis repair construct after anatomic total shoulder arthroplasty can result in difficulty with internal rotation and an increased likelihood of dislocation. Although suture tape has been demonstrated to be an efficacious augment for tendonous repairs elsewhere in th...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087657/ https://www.ncbi.nlm.nih.gov/pubmed/37056453 http://dx.doi.org/10.1177/23259671231162361 |
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author | Wellington, Ian J. Hewitt, Cory R. Hawthorne, Benjamin C. Mancini, Michael R. Dorsey, Caitlin G. Quintana, Julio O. Talamo, Michael Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Sethi, Paul M. |
author_facet | Wellington, Ian J. Hewitt, Cory R. Hawthorne, Benjamin C. Mancini, Michael R. Dorsey, Caitlin G. Quintana, Julio O. Talamo, Michael Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Sethi, Paul M. |
author_sort | Wellington, Ian J. |
collection | PubMed |
description | BACKGROUND: Failure of a subscapularis repair construct after anatomic total shoulder arthroplasty can result in difficulty with internal rotation and an increased likelihood of dislocation. Although suture tape has been demonstrated to be an efficacious augment for tendonous repairs elsewhere in the body, it has not been investigated as a method for augmenting subscapularis peel repairs. PURPOSE: To determine the biomechanical efficacy of suture tape augmentation for the repair of a subscapularis peel. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve human cadaveric shoulders underwent a subscapularis peel. Specimens were randomly split into 2 groups: 6 specimens underwent repair using a transosseous bone tunnel technique with 3 high-strength sutures placed with a Mason-Allen configuration (control group), and 6 specimens underwent the control repair using augmentation with 2 suture tapes placed in an inverted mattress fashion and secured to the proximal humerus using a suture anchor (augmentation group). Shoulders underwent biomechanical testing to compare repair displacement with cyclic loading, load at ultimate failure, and construct stiffness. RESULTS: There were no significant between-group differences in displacement after cyclic loading at the superior (P = .87), middle (P = .47), or inferior (P = .77) portions of the subscapularis tendon. Load to failure was significantly greater in the augmentation group (585.1 ± 97.4 N) than in the control group (358.5 ± 81.8 N) (P = .001). Stiffness was also greater in the augmentation group (71.8 ± 13.7 N/mm) when compared with the control group (48.7 ± 5.7 N/mm) (P = .003). CONCLUSION: Subscapularis peel repair with augmentation via 2 inverted mattress suture tapes secured with an anchor in the proximal humerus conferred significantly greater load at ultimate failure and construct stiffness when compared with a traditional repair using 3 Mason-Allen sutures. There was no difference in repair displacement with cyclic loading between the repair groups. CLINICAL RELEVANCE: Suture tape augmentation of subscapularis peel repairs after shoulder arthroplasty provides an effective segment to the strength of the repair. |
format | Online Article Text |
id | pubmed-10087657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-100876572023-04-12 Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation for Subscapularis Peel Repair Wellington, Ian J. Hewitt, Cory R. Hawthorne, Benjamin C. Mancini, Michael R. Dorsey, Caitlin G. Quintana, Julio O. Talamo, Michael Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Sethi, Paul M. Orthop J Sports Med Article BACKGROUND: Failure of a subscapularis repair construct after anatomic total shoulder arthroplasty can result in difficulty with internal rotation and an increased likelihood of dislocation. Although suture tape has been demonstrated to be an efficacious augment for tendonous repairs elsewhere in the body, it has not been investigated as a method for augmenting subscapularis peel repairs. PURPOSE: To determine the biomechanical efficacy of suture tape augmentation for the repair of a subscapularis peel. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve human cadaveric shoulders underwent a subscapularis peel. Specimens were randomly split into 2 groups: 6 specimens underwent repair using a transosseous bone tunnel technique with 3 high-strength sutures placed with a Mason-Allen configuration (control group), and 6 specimens underwent the control repair using augmentation with 2 suture tapes placed in an inverted mattress fashion and secured to the proximal humerus using a suture anchor (augmentation group). Shoulders underwent biomechanical testing to compare repair displacement with cyclic loading, load at ultimate failure, and construct stiffness. RESULTS: There were no significant between-group differences in displacement after cyclic loading at the superior (P = .87), middle (P = .47), or inferior (P = .77) portions of the subscapularis tendon. Load to failure was significantly greater in the augmentation group (585.1 ± 97.4 N) than in the control group (358.5 ± 81.8 N) (P = .001). Stiffness was also greater in the augmentation group (71.8 ± 13.7 N/mm) when compared with the control group (48.7 ± 5.7 N/mm) (P = .003). CONCLUSION: Subscapularis peel repair with augmentation via 2 inverted mattress suture tapes secured with an anchor in the proximal humerus conferred significantly greater load at ultimate failure and construct stiffness when compared with a traditional repair using 3 Mason-Allen sutures. There was no difference in repair displacement with cyclic loading between the repair groups. CLINICAL RELEVANCE: Suture tape augmentation of subscapularis peel repairs after shoulder arthroplasty provides an effective segment to the strength of the repair. SAGE Publications 2023-04-06 /pmc/articles/PMC10087657/ /pubmed/37056453 http://dx.doi.org/10.1177/23259671231162361 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Wellington, Ian J. Hewitt, Cory R. Hawthorne, Benjamin C. Mancini, Michael R. Dorsey, Caitlin G. Quintana, Julio O. Talamo, Michael Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Sethi, Paul M. Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation for Subscapularis Peel Repair |
title | Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation
for Subscapularis Peel Repair |
title_full | Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation
for Subscapularis Peel Repair |
title_fullStr | Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation
for Subscapularis Peel Repair |
title_full_unstemmed | Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation
for Subscapularis Peel Repair |
title_short | Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation
for Subscapularis Peel Repair |
title_sort | biomechanical evaluation of the efficacy of suture tape augmentation
for subscapularis peel repair |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087657/ https://www.ncbi.nlm.nih.gov/pubmed/37056453 http://dx.doi.org/10.1177/23259671231162361 |
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