The role of sagittal axis in biceps tenodesis for superior capsular reconstruction in massive irreparable rotator cuff tears.

BACKGROUND

This study aims to compare histopathological results following a 6-week postoperative follow-up of biceps tenodesis (BT) at 1/3 median, 1/3 posterior, and 1/3 anterior locations to the rotator cuff footprint (RCF) in cases of massive irreparable rotator cuff tears (MIRCT).

MATERIALS AND METHODS

Thirty rabbits were assigned to three groups. BT for superior capsular reconstruction (SCR) was performed on rabbits 1-10 at the 1/3 median part of the RCF along the sagittal axis using a transosseous reinforced suture with the modified Mason-Allen technique, maintaining consistent pressure in the groove (Group 1). In rabbits 11-20 (Group 2), tenodesis was performed 1/3 posterior to the RCF, while rabbits 21-30 (Group 3) underwent tenodesis 1/3 anterior to the RCF. Following the 6-week follow-up, the shoulders were excised en bloc, and histopathological evaluation was conducted using a modified Bonar's scale. Results were statistically compared among the groups.

RESULTS

The level of cell morphology was significantly lower in Group 2 compared to the other groups (p < 0.05). The extracellular matrix level was also significantly lower in Group 2 compared to the others (p < 0.05). There were no statistically significant differences in collagen levels across Groups 1, 2, and 3 (p > 0.05), nor in cellularity levels among the groups (p > 0.05). General score evaluation levels were significantly lower in Group 2 than in the other groups (p < 0.05).

DICSUSSION

BT performed on the 1/3 posterior part of the RCF demonstrated greater success compared to procedures conducted at the 1/3 median and 1/3 anterior locations for MIRCT.