The Novel Arthroscopic Subscapular Quadriceps Tendon-bone Sling Procedure Provides Increased Stability in Shoulder Cadavers with Severe Glenoid Bone Loss

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2020 Feb 16

PMID 32060592

Citations 2

Authors

Jan Arild Klungsoyr

Terje Vagstad

Manuel Ferle

Jon Olav Drogset

Solveig Roth Hoff

Andreas F Dalen

Christof Hurschler

Christian von Falck

Peter Klungsoyr

Affiliations

Soon will be listed here.

Abstract

Purpose: Treatment of anterior glenoid bone loss in patients with recurrent anterior shoulder instability is a challenge. The subscapular sling method with quadriceps tendon bone (QTB) graft is a modification of the subscapular sling with a semitendinosus (ST) graft. The aim of the study was to test the biomechanical stability of the QTB sling procedure in human shoulder cadavers with severe anterior glenoid bone loss.

Methods: Fourteen cadaveric shoulders were tested with a force-moment-guided robot in three conditions: physiologically intact, anterior glenoid bone resection, and the subscapular sling procedure with a QTB graft. Joint stability was measured in anterior, anterior inferior and inferior directions in four glenohumeral joint positions: 0° and 60° of glenohumeral abduction, with each at 0° and 60° of external rotation. Maximum external rotation was measured at 0° and 60° glenohumeral abduction. Computer tomography scans were obtained preoperatively to plan the glenoid bone resection, as well as postoperatively to calculate the proportion of the glenoid bone actually resected.

Results: Significantly decreased translations were observed in the shoulders with the QTB sling compared to the intact joint and the glenoid bone loss model. No significant differences in maximum external rotation were observed between the three different conditions.

Conclusion: This biomechanical study revealed a significant stabilizing effect of the arthroscopic subscapular QTB graft sling procedure in human shoulder cadavers without compromising external rotation. Clinical trials may reveal the usefulness of this experimental method.

Citing Articles

Biomechanical comparison shows increased stability of an arthroscopic subscapular sling procedure compared to an open Latarjet reconstruction for anterior shoulder instability in specimens with major glenoid bone defect.

Vagstad T, Klungsoyr J, Bjerknes C, Klungsoyr P, Skrede A, Dalen A J Exp Orthop. 2024; 11(3):e70015.

PMID: 39314811 PMC: 11417344. DOI: 10.1002/jeo2.70015.

Dynamic and Static Stabilization of Anterior Shoulder Instability With the Subscapular Sling Procedure.

Klungsoyr J, Vagstad T, Klungsoyr P, Hellevik A, Drogset J Arthrosc Tech. 2021; 10(7):e1773-e1781.

PMID: 34336575 PMC: 8322630. DOI: 10.1016/j.eats.2021.03.027.

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