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Arthroscopic Rotator Interval Closure

Effect of Sutures on Glenohumeral Motion and Anterior-Posterior Translation

From the Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York

^* Address correspondence to Laith M. Jazrawi, MD, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003 (e-mail: ljazrawi{at}aol.com).

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°), external rotation (mean, 10°), 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.

Key Words: arthroscopy • rotator interval closure • biomechanics • range of motion • glenohumeral translation

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