Open AccessDoes the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study
Author(s) -
Felix Porschke,
Philip-Christian Nolte,
Christian Knye,
Christel Weiß,
Stefan Studier-Fischer,
Paul Alfred Gruetzner,
Thorsten Guehring,
Marc Schnetzke
Publication year - 2022
Publication title -
orthopaedic journal of sports medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 35
ISSN - 2325-9671
DOI - 10.1177/23259671211066887
Subject(s) - medicine , cadaveric spasm , rotator cuff , shoulders , tendon , tears , surgery , biomechanics , supraspinatus muscle , anatomy
Background: The benefits of the interval slide (IS) procedure in retracted rotator cuff tears remain controversial.Purpose: The purpose was to evaluate the effect of the IS procedure on repair tension (RT). It was hypothesized that the IS procedure (anterior IS [AIS], posterior IS [PIS], and intra-articular capsular release [CR]) would reduce the RT of a supraspinatus tendon.Study Design: Controlled laboratory study.Methods: A total of 31 Thiel-embalmed human cadaveric shoulders (mean age, 74 years; range, 68-84 years) were tested. Full-thickness supraspinatus tendon tears were created, and 1 cm of tendon was resected to simulate a retracted defect. Shoulders were randomized into intervention (n = 16) and control (n = 15) groups. In all shoulders, the load during tendon reduction to footprint was measured, an endpoint was defined as maximum tendon lateralization before 50 N was reached, and the RT (load during lateralization to endpoint) of the native tendon (t 1 ) was evaluated. In the intervention group, AIS (t 2 ), PIS (t 3 ), and CR (t 4 ) were performed in order, with RT measurement after each step. In the control group, RT was assessed at the same time points without the intervention.Results: A complete reduction of the tendon was not achieved in any of the shoulders. Mean maximum lateralization was 6.7 ± 1.30 mm, with no significant differences between groups. In the intervention group, the overall IS procedure reduced RT about 47.0% (t 1 vs t 4 : 38.7 ± 3.9 vs 20.5 ± 12.3 N; P < .001). AIS reduced RT significantly (t 1 vs t 2 : 38.7 ± 3.9 vs 27.4 ± 10.5 N; P < .001), whereas subsequent PIS (t 2 vs t 3 : 27.4 ± 10.5 vs 23.2 ± 12.4 N; P = .27) and CR (t 3 vs t 4 : 23.2 ± 12.4 vs 20.5 ± 12.3 N; P = .655) did not additionally reduce tension. Comparison between groups at t 4 revealed a reduction of RT of about 47.8% (control vs intervention: 39.3 ± 4.0 vs 20.5 ± 12.3 N; P < .001).Conclusion: The IS procedure reduces RT of the supraspinatus tendon in human cadaveric shoulders. However, performing PIS and CR subsequent to AIS does not reduce tension additionally.Clinical Relevance: These findings provide surgeons with a biomechanical rationale regarding the efficacy of the IS procedure.