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Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study

BACKGROUND: The benefits of the interval slide (IS) procedure in retracted rotator cuff tears remain controversial. PURPOSE: The purpose was to evaluate the effect of the IS procedure on repair tension (RT). It was hypothesized that the IS procedure (anterior IS [AIS], posterior IS [PIS], and intra-...

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Autores principales: Porschke, Felix, Nolte, Philip Christian, Knye, Christian, Weiss, Christel, Studier-Fischer, Stefan, Gruetzner, Paul Alfred, Guehring, Thorsten, Schnetzke, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761884/
https://www.ncbi.nlm.nih.gov/pubmed/35047647
http://dx.doi.org/10.1177/23259671211066887
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author Porschke, Felix
Nolte, Philip Christian
Knye, Christian
Weiss, Christel
Studier-Fischer, Stefan
Gruetzner, Paul Alfred
Guehring, Thorsten
Schnetzke, Marc
author_facet Porschke, Felix
Nolte, Philip Christian
Knye, Christian
Weiss, Christel
Studier-Fischer, Stefan
Gruetzner, Paul Alfred
Guehring, Thorsten
Schnetzke, Marc
author_sort Porschke, Felix
collection PubMed
description BACKGROUND: The benefits of the interval slide (IS) procedure in retracted rotator cuff tears remain controversial. PURPOSE: The purpose was to evaluate the effect of the IS procedure on repair tension (RT). It was hypothesized that the IS procedure (anterior IS [AIS], posterior IS [PIS], and intra-articular capsular release [CR]) would reduce the RT of a supraspinatus tendon. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 31 Thiel-embalmed human cadaveric shoulders (mean age, 74 years; range, 68-84 years) were tested. Full-thickness supraspinatus tendon tears were created, and 1 cm of tendon was resected to simulate a retracted defect. Shoulders were randomized into intervention (n = 16) and control (n = 15) groups. In all shoulders, the load during tendon reduction to footprint was measured, an endpoint was defined as maximum tendon lateralization before 50 N was reached, and the RT (load during lateralization to endpoint) of the native tendon (t(1)) was evaluated. In the intervention group, AIS (t(2)), PIS (t(3)), and CR (t(4)) were performed in order, with RT measurement after each step. In the control group, RT was assessed at the same time points without the intervention. RESULTS: A complete reduction of the tendon was not achieved in any of the shoulders. Mean maximum lateralization was 6.7 ± 1.30 mm, with no significant differences between groups. In the intervention group, the overall IS procedure reduced RT about 47.0% (t(1) vs t(4): 38.7 ± 3.9 vs 20.5 ± 12.3 N; P < .001). AIS reduced RT significantly (t(1) vs t(2): 38.7 ± 3.9 vs 27.4 ± 10.5 N; P < .001), whereas subsequent PIS (t(2) vs t(3): 27.4 ± 10.5 vs 23.2 ± 12.4 N; P = .27) and CR (t(3) vs t(4): 23.2 ± 12.4 vs 20.5 ± 12.3 N; P = .655) did not additionally reduce tension. Comparison between groups at t(4) revealed a reduction of RT of about 47.8% (control vs intervention: 39.3 ± 4.0 vs 20.5 ± 12.3 N; P < .001). CONCLUSION: The IS procedure reduces RT of the supraspinatus tendon in human cadaveric shoulders. However, performing PIS and CR subsequent to AIS does not reduce tension additionally. CLINICAL RELEVANCE: These findings provide surgeons with a biomechanical rationale regarding the efficacy of the IS procedure.
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spelling pubmed-87618842022-01-18 Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study Porschke, Felix Nolte, Philip Christian Knye, Christian Weiss, Christel Studier-Fischer, Stefan Gruetzner, Paul Alfred Guehring, Thorsten Schnetzke, Marc Orthop J Sports Med Article BACKGROUND: The benefits of the interval slide (IS) procedure in retracted rotator cuff tears remain controversial. PURPOSE: The purpose was to evaluate the effect of the IS procedure on repair tension (RT). It was hypothesized that the IS procedure (anterior IS [AIS], posterior IS [PIS], and intra-articular capsular release [CR]) would reduce the RT of a supraspinatus tendon. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 31 Thiel-embalmed human cadaveric shoulders (mean age, 74 years; range, 68-84 years) were tested. Full-thickness supraspinatus tendon tears were created, and 1 cm of tendon was resected to simulate a retracted defect. Shoulders were randomized into intervention (n = 16) and control (n = 15) groups. In all shoulders, the load during tendon reduction to footprint was measured, an endpoint was defined as maximum tendon lateralization before 50 N was reached, and the RT (load during lateralization to endpoint) of the native tendon (t(1)) was evaluated. In the intervention group, AIS (t(2)), PIS (t(3)), and CR (t(4)) were performed in order, with RT measurement after each step. In the control group, RT was assessed at the same time points without the intervention. RESULTS: A complete reduction of the tendon was not achieved in any of the shoulders. Mean maximum lateralization was 6.7 ± 1.30 mm, with no significant differences between groups. In the intervention group, the overall IS procedure reduced RT about 47.0% (t(1) vs t(4): 38.7 ± 3.9 vs 20.5 ± 12.3 N; P < .001). AIS reduced RT significantly (t(1) vs t(2): 38.7 ± 3.9 vs 27.4 ± 10.5 N; P < .001), whereas subsequent PIS (t(2) vs t(3): 27.4 ± 10.5 vs 23.2 ± 12.4 N; P = .27) and CR (t(3) vs t(4): 23.2 ± 12.4 vs 20.5 ± 12.3 N; P = .655) did not additionally reduce tension. Comparison between groups at t(4) revealed a reduction of RT of about 47.8% (control vs intervention: 39.3 ± 4.0 vs 20.5 ± 12.3 N; P < .001). CONCLUSION: The IS procedure reduces RT of the supraspinatus tendon in human cadaveric shoulders. However, performing PIS and CR subsequent to AIS does not reduce tension additionally. CLINICAL RELEVANCE: These findings provide surgeons with a biomechanical rationale regarding the efficacy of the IS procedure. SAGE Publications 2022-01-12 /pmc/articles/PMC8761884/ /pubmed/35047647 http://dx.doi.org/10.1177/23259671211066887 Text en © The Author(s) 2022 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
Porschke, Felix
Nolte, Philip Christian
Knye, Christian
Weiss, Christel
Studier-Fischer, Stefan
Gruetzner, Paul Alfred
Guehring, Thorsten
Schnetzke, Marc
Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title_full Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title_fullStr Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title_full_unstemmed Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title_short Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
title_sort does the interval slide procedure reduce supraspinatus tendon repair tension?: a biomechanical cadaveric study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761884/
https://www.ncbi.nlm.nih.gov/pubmed/35047647
http://dx.doi.org/10.1177/23259671211066887
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