Supraspinatus tendon tears are common and often propagate into larger tears that include the infraspinatus tendon, resulting in loss of function and increased pain. Previously, we showed that the supraspinatus and infraspinatus tendons mechanically interact through a range of rotation angles, potentially shielding the torn supraspinatus tendon from further injury while subjecting the infraspinatus tendon to increased risk of injury. Surgical repair of torn supraspinatus tendons is common, yet the effect of the repair on the infraspinatus tendon is unknown. Since we have established a relationship between strain in the supraspinatus and infraspinatus tendons the success of a supraspinatus tendon repair depends on its effect on the loading environment in the infraspinatus tendon. More specifically, the effect of transosseous supraspinatus tendon repair in comparison to one that utilizes suture anchors, as is commonly done with arthroscopic repairs, on this interaction through these joint positions will be evaluated. We hypothesize that at all joint positions evaluated, both repairs will restore the interaction between the two tendons. For both repairs, (1) increasing supraspinatus tendon load will increase infraspinatus tendon strain and (2) altering the rotation angle from internal to external will increase strain in the infraspinatus tendon. Strains were measured in the infraspinatus tendon insertion through a range of joint rotation angles and supraspinatus tendon loads, for the intact, transosseous, and suture anchor repaired supraspinatus tendons. Images corresponding to specific supraspinatus tendon loads were isolated for the infraspinatus tendon insertion for analysis. The effect of supraspinatus tendon repair on infraspinatus tendon strain differed with joint position. Altering the joint rotation did not change strain in the infraspinatus tendon for any supraspinatus tendon condition. Finally, increasing supraspinatus tendon load resulted in an increase in average maximum and decrease in average minimum principal strain in the infraspinatus tendon. There is a significant difference in infraspinatus tendon strain between the intact and arthroscopically (but not transosseous) repaired supraspinatus tendons that increases with greater loads. Results suggest that at low loads neither supraspinatus tendon repair technique subjects the infraspinatus tendon to potentially detrimental loads; however, at high loads, transosseous repairs may be more advantageous over arthroscopic repairs for the health of the infraspinatus tendon. Results emphasize the importance of limiting loading of the repaired supraspinatus tendon and that at low loads, both repair techniques restore the interaction to the intact supraspinatus tendon case.
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e-mail: nelly.andarawis@mountsinai.org
e-mail: andrew.kuntz@uphs.upenn.edu
e-mail: mlramsey2@verizon.net
e-mail: soslowsk@upenn.edu
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March 2011
Research Papers
Effect of Supraspinatus Tendon Repair Technique on the Infraspinatus Tendon
Nelly Andarawis-Puri,
e-mail: nelly.andarawis@mountsinai.org
Nelly Andarawis-Puri
Mount Sinai School of Medicine
, One Gustave L. Levy Place, Box 1188, New York, NY 10029
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Andrew F. Kuntz,
Andrew F. Kuntz
Department of Orthopaedic Surgery,
e-mail: andrew.kuntz@uphs.upenn.edu
Hospital of the University of Pennsylvania
, 2 Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104
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Matthew L. Ramsey,
Matthew L. Ramsey
Rothman Institute,
e-mail: mlramsey2@verizon.net
Thomas Jefferson University
, Philadelphia, PA 19107
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Louis J. Soslowsky
Louis J. Soslowsky
McKay Orthopaedic Research Laboratory,
e-mail: soslowsk@upenn.edu
University of Pennsylvania
, 424 Stemmler Hall, Philadelphia, PA 19104–6081
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Nelly Andarawis-Puri
Mount Sinai School of Medicine
, One Gustave L. Levy Place, Box 1188, New York, NY 10029e-mail: nelly.andarawis@mountsinai.org
Andrew F. Kuntz
Department of Orthopaedic Surgery,
Hospital of the University of Pennsylvania
, 2 Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104e-mail: andrew.kuntz@uphs.upenn.edu
Matthew L. Ramsey
Rothman Institute,
Thomas Jefferson University
, Philadelphia, PA 19107e-mail: mlramsey2@verizon.net
Louis J. Soslowsky
McKay Orthopaedic Research Laboratory,
University of Pennsylvania
, 424 Stemmler Hall, Philadelphia, PA 19104–6081e-mail: soslowsk@upenn.edu
J Biomech Eng. Mar 2011, 133(3): 031008 (6 pages)
Published Online: February 7, 2011
Article history
Received:
August 29, 2010
Revised:
December 15, 2010
Posted:
December 22, 2010
Published:
February 7, 2011
Online:
February 7, 2011
Citation
Andarawis-Puri, N., Kuntz, A. F., Ramsey, M. L., and Soslowsky, L. J. (February 7, 2011). "Effect of Supraspinatus Tendon Repair Technique on the Infraspinatus Tendon." ASME. J Biomech Eng. March 2011; 133(3): 031008. https://doi.org/10.1115/1.4003326
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