Passive tension and gap formation of rotator cuff repairs

• Published in: Journal of shoulder and elbow surgery Vol. 13; no. 6; pp. 664 - 667
• Main Authors: Reilly, Peter, Bull, Anthony M.J., Amis, Andrew A., Wallace, Andrew L., Richards, Andrew, Hill, Adam M., Emery, Roger J.H.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-11-2004; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Biomechanical Phenomena; Cadaver; Compressive Strength; Diseases of the osteoarticular system; Female; Humans; Male; Medical sciences; Middle Aged; Orthopedic Procedures - methods; Posture; Range of Motion, Articular - physiology; Recovery of Function; Risk Factors; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder Joint - injuries; Shoulder Joint - surgery; Sprains and Strains - surgery; Human; Position; Use; Break; Intraoperative; Treatment; Surgery; Shoulder; Gap; Tension; Bone; Technique; Repair; Arm; Formation; Rotator cuff; Tendon
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2004.03.011

The objectives of this study were to quantify the relationship between passive tension of rotator cuff repairs and arm position and to examine the effect of this tension on repair gap formation. Five patients undergoing open surgical rotator cuff repair of the supraspinatus tendon were recruited. Tendon tension was recorded as the supraspinatus was advanced into a bone trough and secured. The relationship between arm position and repair tension was then measured. Standardized rotator cuff tears were created in 3 cadaveric shoulders and repaired by use of the intraoperative technique. The difference in tension measured between 0° and 30° abduction was statically applied for 24 hours and the gap formation measured. Repair tension increased with advancement of the supraspinatus tendon into the bone trough. Abduction reduced the repair load. The mean reduction in load by 30° abduction was 34 N. Twenty-four hours of 34-N loading caused gap formation of 9 mm in cadaveric rotator cuff repairs. Passive tension in surgically repaired rotator cuffs may contribute to repair failure and can be modified by arm positioning.