Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: A biomechanical cadaveric study

Abstract

Background: There have been many clinical reports of patch graft surgery for irreparable rotator cuff tears. However, the retear rate of the patch graft is relatively high because of the lack of superior stability, causing subacromial abrasions. Purpose: To compare superior stability among 3 types of patch grafting for simulated irreparable rotator cuff tears. Study Design: Controlled laboratory study. Methods: Eight cadaveric shoulders were tested in a custom shoulder testing system. Superior translation of the humerus, subacromial contact pressure, and glenohumeral joint force were quantified in the following 5 conditions: (1) when the rotator cuff was intact, (2) after cutting the supraspinatus tendon, (3) after the patch graft to reconstruct the supraspinatus tendon, (4) after the patch graft to reconstruct the superior capsule, and (5) after the patch graft to reconstruct both the supraspinatus tendon and superior capsule. While the graft was sutured to the torn tendon in condition 3, the graft was attached to the superior glenoid in condition 4. Results: Compared with values for intact rotator cuffs, cutting the supraspinatus tendon significantly increased superior translation (P