Biomechanical comparison of lesser tuberosity osteotomy versus subscapularis tenotomy in total shoulder arthroplasty

Steven A. Giuseffi, Prasit Wongtriratanachai, Hiromichi Omae, Akin Cil, Mark E. Zobitz, Kai Nan An, John W. Sperling, Scott P. Steinmann

研究成果: Article同行評審

48 引文 斯高帕斯(Scopus)

摘要

Background: Total shoulder arthroplasty is traditionally performed through an anterior deltopectoral exposure with subscapularis tenotomy. Postoperative subscapularis dysfunction is common and adversely affects clinical outcomes. Consequently, surgeon interest in lesser tuberosity osteotomy has grown in an effort to improve subscapularis repair strength. This study investigated the biomechanical strength of subscapularis tenotomy vs lesser tuberosity osteotomy in the setting of total shoulder arthroplasty. Materials and methods: Uncemented humeral prostheses were placed in 20 paired upper extremities from 10 cadavers. For each respective cadaver, 1 limb underwent lesser tuberosity osteotomy and the contralateral limb underwent subscapularis tenotomy. The cadaveric specimens then underwent cyclic displacement and maximum load to failure testing. Results: The subscapularis tenotomy specimens exhibited significantly less cyclic displacement (0.8 mm) than the osteotomy group (1.8 mm), with a 95% confidence interval (CI) for the difference of 0.5 to 1.5 mm (P = 0.002). The maximum load to failure was 439 ± 96 N for tenotomy and 447 ± 89 N for osteotomy (95% CI for the difference of -58 to 75), which was not significant (P = .78). Conclusion: Lesser tuberosity osteotomy was not significantly stronger than subscapularis tenotomy in maximum load to failure testing, with minimal clinical significance set at 100 N. Subscapularis tenotomy repair showed statistically significant less cyclic displacement than lesser tuberosity osteotomy. Further research is needed to clarify how the biomechanical results immediately after subscapularis tenotomy and lesser tuberosity osteotomy correlate with clinical outcomes.

原文English
頁(從 - 到)1087-1095
頁數9
期刊Journal of Shoulder and Elbow Surgery
21
發行號8
DOIs
出版狀態Published - 2012 八月

All Science Journal Classification (ASJC) codes

  • 手術
  • 骨科和運動醫學

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