Modified <i>superior capsule</i> reconstruction using the <i>peroneus longus</i> for irreparable massive rotator-cuff tears: A cadaveric study.

Abstract

Irreparable massive rotator cuff tears (IMRCTs) present substantial treatment challenges, highlighting the necessity of making effective treatments available.  To evaluate the biomechanical characteristics of a modified procedure of superior capsule reconstruction (mSCR) employing the autologous peroneus longus tendon for the treatment of irreparable massive rotator-cuff tears (IMRCTs), encompassing the entire supraspinatus tendon and 50% of the infraspinatus tendon.  Seven cadaveric specimens were tested at 0°, 30°, and 60° <i>glenohumeral</i> abduction under the following three conditions: (1) intact, (2) IMRCT, and (3) mSCR using the autologous <i>peroneus longus</i> tendon. <i>Humeral</i> rotational range of motion (ROM), <i>superior</i> translation of the <i>humeral</i> head, and <i>subacromial</i> contact pressure were measured. Repeated-measures ANOVA was followed by Tukey's post hoc test to perform statistical analyses.  At all the abduction angles, <i>superior</i> translation of the <i>humeral</i> head and <i>subacromial</i> contact pressure were higher in the IMRCT group than in the intact group but were significantly lower in the mSCR group than in the IMRCT group. All these differences were statistically significant (<i>P </i>< 0.05).  The mSCR procedure can reduce the <i>superior</i> translation of the <i>humeral</i> head and <i>subacromial</i> contact pressure without limiting <i>humeral</i> ROM in IMRCTs. Utilizing mSCR with the <i>peroneus longus</i> tendon may serve as a therapeutic approach for IMRCTs.