Evaluation of the subscapularis split created with passive rotation during arthroscopic dynamic anterior stabilization (DAS): A cadaveric study - 24/08/21
Abstract |
Introduction |
The purpose of the present study was to analyze the ability to create a subscapularis split by passive rotation of the arm during dynamic anterior stabilization (DAS) and to analyze the new geometry of the long head of the biceps LHB.
Hypothesis |
The hypothesis was that this passive simple technique can create subscapularis split without additional dissection giving rise to new position of LHB with a new stabilization function.
Material and methods |
A technique of subscapularis split using the LHB was used in 12 fresh-frozen human cadaveric shoulders. A subscapularis split was created by passive rotation of the arm after the LHB is shuttled into the joint during DAS. The length of the subscapularis split, post-DAS position and length of the LHB, and the angulation of the LHB relative to bicipital groove were measured after DAS and if this new geometry can give a new dynamic effect on subscapularis muscle.
Results |
The mean length of the subscapular split after maximal rotation was 20.4±6.0mm (range: 10–32mm). The mean elongation of the LHB was 0.6±1.4mm (range: −1 to +3mm). The final angle of the LHB relative to the bicipital groove was 45±5 degrees (range: 41 to 55 degrees).
Discussion |
There is no need to create a distinct split prior to DAS. Additionally, DAS maintains the length-tension relationship of the LHB. The post-procedure medial angulation of the LHB relative to the bicipital groove may provide a lowering of the subscapularis, helping explain the anterior reinforcement of this technique.
Level of evidence |
Basic science study, cadaver study.
Le texte complet de cet article est disponible en PDF.Keywords : Shoulder instability, Bankart, Sling effect, Hammock, Latarjet, Treatment
Plan
Vol 107 - N° 5
Article 102934- septembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.