000			04223nam a22005057a 4500
700			_aHaislup, Brett _bMUMH _cOrthopaedic Surgery Residency _dMD
700			_aLindsey, Sierra _bMUMH _cOrthopaedic Surgery Residency _dMD
700			_aTarapore, Rae _bMUMH _cOrthopaedic Surgery Residency _dMD
008			231220s20232023 xxu||||| |||| 00| 0 eng d
022			_a1058-2746
024			_a10.1016/j.jse.2023.08.027 [doi]
024			_aS1058-2746(23)00706-1 [pii]
040			_aOvid MEDLINE(R)
099			_a37777043
245			_aBiomechanics of Subscapularis V-shaped Tenotomy compared to Standard Tenotomy.
251			_aJournal of Shoulder & Elbow Surgery. 2023 Sep 28
252			_aJ Shoulder Elbow Surg. 2023 Sep 28
253			_aJournal of shoulder and elbow surgery
260			_c2023
260			_fFY2024
260			_p2023 Sep 28
265			_saheadofprint
265			_tPublisher
266			_d2023-12-20
520			_aCONCLUSION: This study showed that VT and ST demonstrated equivalent stiffness, displacement, and load to failure. VT had the benefit of less creep throughout the first three cycles, although there was no difference from cycle 4 to 3,000. The VT had equivalent biomechanical properties to the ST at time zero, an important first step in our understanding of the technique. The VT technique warrants further clinical study to determine if the technique has clinical benefits over ST following aTSA. Copyright © 2023. Published by Elsevier Inc.
520			_aINTRODUCTION: Subscapularis function is critical after anatomic total shoulder arthroplasty (aTSA). Recently, however, a technique has been described that features a chevron or V-shaped subscapularis tendon cut (VT). This biomechanical study compared repair of the standard tenotomy (ST), made perpendicular to the subscapularis fibers, to repair of the novel VT using cyclic displacement, creep, construct stiffness, and load to failure.
520			_aMETHODS: This biomechanical study used six pairs of fresh frozen paired cadaveric shoulder specimens. One specimen per each pair underwent VT, the other ST. Subscapularis tenotomy was performed 1 cm from the insertion onto the lesser tuberosity. For VT the apex of the V was 3cm from the lesser tuberosity. After tenotomy, each humerus underwent humeral head arthroplasty. Eight figure-of-eight sutures were used to repair the tenotomy (Ethibond Excel; Ethicon, US LLC, Somerville, NJ, USA). Specimens were cyclically loaded from 2N to 100N at 45 degrees abduction at a rate of 1 Hz for 3000 cycles. Cyclic displacement, creep, and stiffness, and load to failure were measured.
520			_aRESULTS: Cyclic displacement did not differ significantly between the ST and VT from 1 to 3,000 cycles. The difference in displacement between the V-shaped and standard tenotomy at 3,000 cycles was 1.57mm (3.66 +/- 1.55 mm vs. 5.1 +/- 2.8 mm p= .31, respectively). At no point was the V-shape tenotomy (VT) above 3mm of average displacement, whereas the standard tenotomy (ST) averaged 3mm of displacement after 3 cycles. Creep was significantly lower for VT in cycles 1 through 3 . For all cycles stiffness was not significantly different in the VT group compared to the ST group. Load to failure was not statistically significant in the VT compared to the standard tenotomy throughout all cycles (253.2 +/- 27.7 N vs. 213.3 +/- 76.04 N; p= .25, respectively). The range of load to failure varied from 100-301 N for standard tenotomy compared to 216-308 N for VT.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aCurtis National Hand Center
651			_aMedStar Union Memorial Hospital
656			_aOrthopaedic Surgery
656			_aOrthopaedic Surgery Residency
656			_aOrthopaedic Surgery Residency D
656			_aOrthopedics
657			_aJournal Article
700			_aAbbasi, Pooyan _bCURT
700			_aMurthi, Anand M _bMUMH
700			_aWright, Melissa A _bMUMH
790			_aHaislup BD, Lindsey S, Tarapore R, Abbasi P, Wright MA, Murthi AM
856			_uhttps://dx.doi.org/10.1016/j.jse.2023.08.027 _zhttps://dx.doi.org/10.1016/j.jse.2023.08.027
942			_cART _dArticle
999			_c13620 _d13620