Indexing
CÁC SỐ TỪ 2011-2023
Tạp chí Y Dược Học
Abstract
Introduction: Irreparable large and massive rotator cuff tears are frequently accompanied by glenohumeral instability and ascent of the humeral head, which in turn promote progressive degenerative changes of the shoulder joint. Superior capsular reconstruction (SCR) using an autologous long head of the biceps (LHB) tendon has been proposed as a means to restore superior constraint and improve joint biomechanics. The purpose of this cadaveric study was to determine whether SCR with an LHB autograft increases resistance to superior translation of the humeral head in the setting of large-to-massive rotator cuff deficiency.
Methods: Ten shoulders from five fresh-frozen human cadavers were used. Large and massive rotator cuff tears were created by detaching the supraspinatus and infraspinatus tendons from their insertion on the greater tuberosity. The force required to translate the humeral head 1.5 cm in the superior direction was recorded before and after SCR using an in-situ LHB autograft. A paired statistical analysis was performed to quantify the biomechanical effect of reconstruction.
Results: After SCR, the force required to produce superior migration of the humeral head increased by 120.6% in the large tear model and by 174.5% in the massive tear model compared with the deficient state (P < 0.05), demonstrating a significant improvement in superior stability.
Conclusion: Superior capsular reconstruction with an autologous LHB tendon substantially enhances resistance to superior humeral head translation in cadaveric shoulders with large and massive rotator cuff tears. These findings support the biomechanical rationale for this technique and underscore the need for clinical studies to corroborate its in vivo effectiveness.
| Published | 2026-06-28 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 16 No. 3 (2026) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2026.3.804 | |
| Keywords | Tổn thương chóp xoay; Tái tạo bao khớp trên; Cơ sinh học khớp vai. |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
/ Cofield RH. Subscapular muscle transposition for repair of chronic rotator cuff tears. Surg Gynecol Obstet. 1982;154(5):667–72.
/ Habermeyer P, Krieter C, Tang KL, Lichtenberg S, Magosch P. A new arthroscopic classification of articular-sided supraspinatus footprint lesions: a prospective comparison with Snyder's and Ellman's classification. J Shoulder Elbow Surg. 2008;17(6):909–13. doi:10.1016/j.jse.2008.06.007
/ Kholinne E, Sun Y, Kwak JM, Kim H, Koh KH, Jeon IH. Failure rate after superior capsular reconstruction with Achilles tendon-bone allograft for irreparable rotator cuff tears. Orthop J Sports Med. 2021;9(5):23259671211002280. doi:10.1177/23259671211002280
/ Adrian SC, Field LD. Biceps transposition for biological superior capsular reconstruction. Arthrosc Tech. 2020;9(6):e841–6. doi:10.1016/j.eats.2020.02.020
/ Sambandam SN, Khanna V, Gul A, Mounasamy V. Rotator cuff tears: an evidence-based approach. World J Orthop. 2015;6(11):902–18. doi:10.5312/wjo.v6.i11.902
/ Bogdanov J, Lan R, Chu TN, Bolia IK, Weber AE, Petrigliano FA. Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment. JSES Rev Rep Tech. 2021;1(4):301–8. doi:10.1016/j.xrrt.2021.05.006
/ Dimock RAC, Malik S, Consigliere P, Imam MA, Narvani AA. Superior capsule reconstruction: what do we know? Arch Bone Jt Surg. 2019;7(1):3–11.
/ Burkhart SS, Denard PJ, Adams CR, Brady PC, Hartzler RU. Arthroscopic superior capsular reconstruction for massive irreparable rotator cuff repair. Arthrosc Tech. 2016;5(6):e1407–18. doi:10.1016/j.eats.2016.08.024
/ Milano G, Marchi G, Bertoni G, et al. Augmented repair of large to massive delaminated rotator cuff tears with autologous long head of the biceps tendon graft: the arthroscopic "cuff-plus" technique. Arthrosc Tech. 2020;9(11):e1683–8. doi:10.1016/j.eats.2020.07.011
/ Kim D, Um J, Lee J, Kim J. Improved clinical and radiologic outcomes seen after superior capsule reconstruction using long head biceps tendon autograft. Arthroscopy. 2021;37(9):2756–67. doi:10.1016/j.arthro.2021.04.006
/ Cheppalli NS, Purudappa PP, Metikala S, et al. Superior capsular reconstruction using the biceps tendon in the treatment of irreparable massive rotator cuff tears improves patient-reported outcome scores: a systematic review. Arthrosc Sports Med Rehabil. 2022;4(3):e1235–43. doi:10.1016/j.asmr.2022.04.003
/ Gupta AK, Hug K, Berkoff DJ, et al. Dermal tissue allograft for the repair of massive irreparable rotator cuff tears. Am J Sports Med. 2012;40(1):141–7. doi:10.1177/0363546511422795
/ Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29(3):459–70. doi:10.1016/j.arthro.2012.10.022
/ Barth J, Olmos MI, Swan J, Barthelemy R, Delsol P, Boutsiadis A. Superior capsular reconstruction with the long head of the biceps autograft prevents infraspinatus retear in massive posterosuperior retracted rotator cuff tears. Am J Sports Med. 2020;48(6):1430–8. doi:10.1177/0363546520912220
/ Han F, Kong CH, Hasan MY, Ramruttun AK, Kumar VP. Superior capsular reconstruction for irreparable supraspinatus tendon tears using the long head of biceps: a biomechanical study on cadavers. Orthop Traumatol Surg Res. 2019;105(2):257–63. doi:10.1016/j.otsr.2018.10.023
/ El-Shaar R, Soin S, Nicandri G, Maloney M, Voloshin I. Superior capsular reconstruction with a long head of the biceps tendon autograft: a cadaveric study. Orthop J Sports Med. 2018;6(7):2325967118785365. doi:10.1177/2325967118785365