Effect of biceps rerouting technique to restore glenohumeral joint stability for large irreparable rotator cuff tears: a cadaveric biomechanical study

Background: The concept of stabilizing the humerus has taken on an important role in the treatment of irreparable cuff tears, and the biceps rerouting (BR) method is considered one of the most effective treatments in this field. The study aimed to evaluate the biomechanical effects of BR for large irreparable rotator cuff tears (LICTs). Methods: A total of 8 cadaveric shoulders were used for testing under 5 conditions: intact shoulder, LICT, partial repair (PR), BR, and biceps rerouting with side-to-side repair (BRSS). Total rotational range of motion was measured at 40 degrees, then 20 degrees, and finally 0 degrees of glenohumeral (GH) abduction. Superior humeral translation and subacromial contact pressure were measured at 0 degrees, 30 degrees, 60 degrees, and 90 degrees of external rotation at each abduction angle. Repeated-measures analyses of variance with Tukey post hoc tests were used for statistical comparisons. Results: Superior humeral translation was significantly decreased in the BR and BRSS conditions compared with the LICT and PR conditions at 0 degrees and 20 degrees of GH abduction (P < .001). BR and BRSS significantly reduced subacromial contact pressure compared with LICT and PR at 0 degrees of GH abduction (P < .001). There was no significant decrease in total rotational range of motion after BR at any abduction angle. Conclusion: BR biomechanically restored shoulder stability without overconstraining range of motion in an LICT model. (C) 2019 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.