Bone and Joint Institute
An in-vitro biomechanical assessment of humeral head migration following irreparable rotator cuff tear and subacromial balloon reconstruction
Document Type
Article
Publication Date
8-1-2020
Journal
Shoulder and Elbow
Volume
12
Issue
4
First Page
265
Last Page
271
URL with Digital Object Identifier
10.1177/1758573219865479
Abstract
© 2019 The British Elbow & Shoulder Society. Background: A resorbable subacromial balloon has been developed to address humeral head migration following posterosuperior rotator cuff tears. The purpose of this experimental assessment was to quantify the effect of balloon augmentation on humeral head position. Methods: Eight cadaveric shoulders were subjected to 0°, 30°, 60° and 90° of abduction via a shoulder simulator. The deltoid was activated at 40N, then 80N. The subscapularis and infraspinatus with teres minor were then applied independently and together to create four muscle activation states for each deltoid load. The shoulder was tested intact, torn, then with the balloon. The centre of the humeral head was tracked using active optical markers. Results: When the rotator cuff was torn, the humeral head translated superior by 1.4 ± 1 mm overall (P = 0.009). Following balloon augment, the humeral head translated inferiorly by 2 ± 2 mm relative to the intact state (P = 0.042), and significantly more anterior than the intact (3 ± 2 mm; P = 0.005) state. Rotator cuff variation was only significantly different when the balloon was used, with the subscapularis translating the humeral head posteriorly (P = 0.006). Discussion: The subacromial balloon inferiorized the humeral head compared to the torn state. Unexpected anterior humeral head translation was attributed to the posterosuperior balloon placement relative to the humeral head.
