The choice of an optimal graft for the superior capsule reconstruction of the shoulder with a massive rotator cuff tear

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Abstract

Background: The study hypothesis is that the knowledge about the mechanical properties of biological tissues will help surgeons to choose a transplant.

Aim: To determine the optimal type of a graft, based on the assessment of the mechanical properties of three types of grafts used for the superior capsule reconstruction of the shoulder joint with a massive rotator cuff tear.

Methods: In the experimental work, 3 types of biological tissues were studied: allografts of the fascia lata and of the dura mater, and the DX Reinforcement Matrix (a dermal ECM xenograft). The experiment was divided into two parts. In the first part, the mechanical strength at rupture of the samples was evaluated and compared, in the second part the resistance of a vertical suture was studied. The tests included uniaxial stretching with the force and strain at rupture recorded.

Results: The fascia lata allograft showed the highest ultimate tensile strength, while the dura mater allograft had the lowest ultimate tensile strength. All the three materials showed rather high values of the rupture strain. The lowest value of the rupture strain was detected for the dura mater allograft — 15.2±2.6%, the highest value was obtained for the dermal ECM xenograft — 63.3±20.8%. The largest value of the fracture stress was recorded for the DX Reinforcement Matrix — 33.5 N. The minimum value was recorded for the fascia lata allograft — 9.9 N.

Conclusion: The fascia lata allograft and DX Reinforcement Matrix have the optimal mechanical characteristics and can be recommended as grafts for the superior capsule reconstruction of the shoulder joint with a massive rotator cuff tear.

About the authors

Daria A. Naida

Main Military Clinical Hospital named after academical N.N. Burdenko

Author for correspondence.
Email: dariaanayda@gmail.com
ORCID iD: 0000-0003-4567-2612

MD

Russian Federation, 3 Hospitalnaya pl., 105094, Moscow

Sergei Yu. Dokolin

Vreden National Medical Center for Traumatology and Orthopedics

Email: sdokolin@gmail.com
SPIN-code: 1993-2304

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Alexander Yu. Kochish

Vreden National Medical Center for Traumatology and Orthopedics

Email: auk1959@mail.ru
SPIN-code: 7522-8250

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Alexander A. Akhpashev

Academy of Postgraduate Education under the FSBU “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia”

Email: akhpashev@gmail.com
ORCID iD: 0000-0002-0977-805X
SPIN-code: 9965-1828

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow

Boris V. Tyulkevich

Main Military Clinical Hospital named after academical N.N. Burdenko

Email: 1983loki@mail.ru

MD

Russian Federation, 3 Hospitalnaya pl., 105094, Moscow

References

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Supplementary files

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2. Fig. 1. Samples of the studied biological tissues: a — fascia lata allograft; b — allograft of the dura mater; с — DX Reinforcement Matrix.

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3. Fig. 2. Testing of a sample using an Instron ElectroPuls E3000 universal servohydraulic machine: a — for the uniaxial tension; b — for the resistance to penetration by the suture material.

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4. Fig. 3. Characteristic graphs of tensile tests. Note. СПБТ — fascia lata allograft; TMO — allograft of the dura mater; БМ — DX Reinforcement Matrix.

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5. Fig. 4. Characteristic schedules of tests for seam retention. Note. СПБТ — fascia lata allograft; TMO — allograft of the dura mater; БМ — DX Reinforcement Matrix.

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6. Fig. 5. The results of the studies of on the characteristics of three tissue samples used for the superior capsule reconstruction of the shoulder joint with a massive rotator cuff tear.

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Copyright (c) 2021 Naida D.A., Dokolin S.Y., Kochish A.Y., Akhpashev A.A., Tyulkevich B.V.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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