Rotator cuff tendon strain correlates with tear propagation |
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| Authors: | Nelly Andarawis-Puri Eric T Ricchetti Louis J Soslowsky |
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| Institution: | 1. Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 South 33rd St, Philadelphia, PA 19104, United States;2. Department of Biomedical Engineering, University of Delaware, 125 East Delaware Avenue, Newark, DE 19716, United States;1. Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA;2. Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA;1. Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan;2. Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Orthpaedic Hokushin Hospital, Sapporo, Hokkaido, Japan;3. Department of Orthopedic Surgery, Rehabilitation Clinic Yamaguchi, Naha, Okinawa, Japan;4. Department of Orthopedic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan;5. Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan;1. Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of ?ód?, ?ód?, Poland;2. FMC Private Medical Centre, ?ód?, Poland;3. Morphometry Division, Department of Pathology, Medical University of ?ód?, ?ód?, Poland;4. Clinic of Orthopaedics and Traumatology, Polish Mother''s Memorial Hospital Research Institute, ?ód?, Poland;1. Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA;2. The Neuroscience Program, Wake Forest University Graduate School of Arts and Sciences, Winston-Salem, NC, USA;3. Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA;4. Department of Pathology (Comparative Medicine) and the Wake Forest Primate Center, Wake Forest School of Medicine, Winston-Salem, NC, USA;5. Department of Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA;1. Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA;2. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA;3. Hospital for Special Surgery, New York, NY, USA |
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| Abstract: | Rotator cuff tears are a common tendon injury often requiring surgical treatment. Understanding the relationships between tear size, tendon loading, and tendon strain adjacent to a rotator cuff tear can provide important insights into predicting the likelihood of propagation to larger tears which would influence clinical treatment. Previous studies assume that an increase in strain correlates with an increase in risk of tear propagation. However, these studies did not explicitly investigate these important relationships. Therefore, the objective of this study was to quantify two-dimensional strain fields adjacent to a rotator cuff tendon tear under loading to failure and to assess the relationship between tendon strain and tear size. Sheep infraspinatus tendons were used to evaluate the effect of tear size on principal strains in the region adjacent to the tear. The relationship between strain, tear propagation, and the direction of tear propagation was quantified. Results showed that principal strains linearly correlated with tear propagation and that tear propagation began at strains as low as 1.7%. In addition, tears propagated in the direction of highest maximum and lowest minimum principal strain. Finally, maximum and minimum principal strains were higher and lower, respectively, adjacent to larger tears compared to smaller tears. Findings from this study validate the use of local strain adjacent to a rotator cuff tear as an indicator of the risk and direction of tear propagation. |
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