Arthroscopic rotator interval closure: effect of sutures on glenohumeral motion and anterior-posterior translation

Derek Plausinis, Jonathan T Bravman, Christian Heywood, Frederick J Kummer, Young W Kwon, Laith M Jazrawi
American Journal of Sports Medicine 2006, 34 (10): 1656-61

BACKGROUND: The effect of arthroscopic rotator interval closure on glenohumeral motion and translation is not well understood, nor is the ideal location or number of sutures required for closure.

HYPOTHESIS: The number of arthroscopic rotator interval closure sutures and their placement will have a significant effect on glenohumeral range of motion and anterior-posterior translation.

STUDY DESIGN: Controlled laboratory study.

METHODS: Using a custom testing apparatus, the authors measured range of motion in 12 fresh-frozen cadaveric shoulders; anterior-posterior translation in adduction and neutral rotation was measured in 9. Specimens were initially tested without sutures and then tested after 3 interval closures using a random sequence of (1) an isolated medial suture at the level of the glenoid, (2) an isolated lateral suture 1 cm lateral to the glenoid, or (3) both sutures followed by removal of all sutures.

RESULTS: Analysis of variance demonstrated that interval closure had a significant effect on decreasing flexion (mean, 6 degrees), external rotation (mean, 10 degrees), and anterior translation (mean, 3 mm) of the adducted shoulder. There was no significant difference between the 3 interval closures in any of the tests.

CONCLUSION: Arthroscopic interval closure produced significant decreases in range of motion and anterior-posterior translation. The effects of single lateral or medial suture closures were similar to the use of 2 sutures.

CLINICAL RELEVANCE: This study suggests that the initial effect of arthroscopic rotator interval closure on anterior translation of the shoulder will be similar whether 1 or 2 sutures are used. In vivo studies are necessary to determine if the effect of these 2 methods would be the same over time.

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