Abstract
Tendon mobility is highly relevant in rotator cuff surgery. Objective data about rotator cuff mobility is rare. Tendon mobility still needs to be evaluated subjectively by the surgeon. This study aims to establish a porcine animal model for mobility analysis of the supraspinatus. In this context, we introduce a sensor-enhanced, arthroscopic grasper (SEAG) suitable for objective intraoperative measurements of tendon mobility in clinical praxis. Tendon mobility of 15 fresh porcine cadaver shoulders with artificial rotator cuff tears was evaluated using the SEAG. Mobility characteristics (load–displacement curves, maximum load, stiffness) were studied and inter- and intraobserver agreement (intraclass correlation coefficient (ICC)) were tested. Factors with a potential adverse effect (plastic deformation and rigor mortis) were also evaluated. All shoulders showed characteristic reproducible load–displacement curves with a nonlinear part at the start, followed by a linear part. Mean maximum load was 28.6 N ± 12.5. Mean stiffness was 6.0 N/mm ± 2.6. We found substantial interobserver agreement (ICC 0.672) and nearly perfect intraobserver agreement (0.944) for maximum load measurement. Inter- (0.021) and intraobserver (0.774) agreement for stiffness was lower. Plastic deformation and rigor mortis were excluded. The animal model demonstrates reliable and in vivo-like measurements of tendon mobility. The SEAG is a reliable tool for tendon mobility assessment.
Highlights
Rotator cuff injury is a frequent musculoskeletal disease and causes pain and functional impairment
Tendon mobility is highly relevant in rotator cuff surgery
We introduce a sensor-enhanced, arthroscopic grasper (SEAG) suitable for objective intraoperative measurements of tendon mobility in clinical praxis
Summary
Rotator cuff injury is a frequent musculoskeletal disease and causes pain and functional impairment. Reconstruction of rotator cuff defects has become increasingly important due to advances in surgical techniques and the development of new implants. Despite such progress, a considerable percentage of patients still suffers from a re-tear after tendon reconstruction.[15,34] Clinical and experimental research has focused on the insertion site (bone-implant and implant-tendon interface) of tendon reconstruction. Due to the natural course of tendon retraction and remodeling, the intraoperative mobility of a torn tendon is an important factor.[14,28] Several radiological parameters have been identified as predictors for clinical outcome and re-tear rates.[26,33]. Due to the natural course of tendon retraction and remodeling, the intraoperative mobility of a torn tendon is an important factor.[14,28] Several radiological parameters have been identified as predictors for clinical outcome and re-tear rates.[26,33] Tendon mobility could be an important link or even an explanation for worse outcomes in the presence of a retracted tendon[17,28] or atrophy of the muscle[14,37] in MRI
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