Biomechanical similarities among subscapularis repairs after shoulder arthroplasty

Thiel, Geoffrey S. Van; Wang, Vincent; Wang, Fan-Chia; Nho, Shane J.; Piasecki, Dana P.; Bach, Bernard R.; Romeo, Anthony A.

doi:10.1016/j.jse.2010.01.014

Cited by 67 publications

(79 citation statements)

References 20 publications

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“…19,38 Using this approach, surface strain was computed for the following regions: humerus to tendon-bone insertion (Region 1), tendon-bone insertion to tip of the tendon fibrocartilage (Region 2), and tip of the fibrocartilage to myotendinous junction (a point 10mm further proximal) (Region 3) (Figure 2B). Using the tracking software, segment length (e.g., L1, L2, L3 for Regions 1, 2, and 3, respectively) was defined as the linear distance between the respective markers defining each region.…”

Section: Methodsmentioning

confidence: 99%

Rotator cuff healing after continuous subacromial bupivacaine infusion: an in vivo rabbit study

Friel¹,

Wang²,

Slabaugh³

et al. 2013

Journal of Shoulder and Elbow Surgery

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Background The objective of this study was to evaluate the effects of continuous subacromial bupivacaine infusion on supraspinatus muscle and rotator cuff tendon healing via gross, biomechanical, and histologic analyses. Methods Thirty-three New Zealand White rabbits underwent unilateral supraspinatus transection and rotator cuff repair (RCR). Rabbits were assigned to 1 of 3 groups: (1)RCR only, (2)RCR with continuous saline infusion for 48 hours, or (3)RCR with continuous 0.25% bupivacaine with epinephrine (1:200,000) infusion for 48 hours. Rabbits were sacrificed at either 2 (for histologic assessment) or 8 weeks post-operatively (for biomechanical and histologic assessment). Results Tensile testing showed significantly higher load to failure in intact tendons compared to repaired tendons (p<0.01); however, no statistical differences were detected among RCR only, RCR Saline, and RCR Bupivacaine groups. Histologically, the enthesis of repaired tendons showed increased cellularity and disorganized collagen fibers compared to intact tendons, with no differences between treatment groups. Muscle histology demonstrated scattered degenerative muscle fibers at 2 weeks in both RCR Saline and RCR Bupivacaine, but no degeneration was noted at 8 weeks. Conclusions The healing supraspinatus tendons exposed to bupivacaine infusion showed similar histologic and biomechanical characteristics compared to untreated and saline infused RCR groups. Muscle histology showed fiber damage at 2 weeks for both the saline and bupivacaine treated groups, with no apparent disruption at 8 weeks, suggesting a recovery process. Therefore, subacromial bupivacaine infusion in this rabbit rotator cuff model does not appear to impair muscle or tendon following acute injury and repair. Level Of Evidence Basic science study

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Section: Methodsmentioning

confidence: 99%

Rotator cuff healing after continuous subacromial bupivacaine infusion: an in vivo rabbit study

Friel¹,

Wang²,

Slabaugh³

et al. 2013

Journal of Shoulder and Elbow Surgery

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“…7 To gain access to the glenohumeral joint, the subscapularis tendon may be released by a tenotomy, tendon elevation off bone (''peel''), or osteotomy of the lesser tuberosity. 30 After implantation of the arthroplasty, the subscapularis is repaired for improved stability and function. 24 Despite this, poor healing or rupture of a repaired subscapularis is not uncommon 14,15,22,23,28 and can be associated with weakness, instability, and pain.…”

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confidence: 99%

The return of subscapularis strength after shoulder arthroplasty

Lapner¹,

Wood²,

Zhang³

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…3 Recent efforts to avoid this problem have prompted critical evaluations of how the subscapularis is released, 6,7,12,16 and has even encouraged subscapularis sparing techniques. 8 Several authors have presented improved biomechanical and clinical results using a lesser tuberosity osteotomy.…”

Section: Discussionmentioning

confidence: 99%