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Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

After rotator cuff repair, some surgeons use abduction pillows to unload or protect the repair construct, while others do not.

Question/Purpose

The aim of this study was to determine which type of sling—one with a small or large abduction pillow or one without a pillow—places the repaired rotator cuff in the best position to reduce tension on the supraspinatus.

Methods

An X-ray study was performed on asymptomatic subjects to determine what position the shoulder is placed in when wearing a sling with or without an abduction pillow. Positions were then reproduced in human cadaveric shoulders using a custom-made testing jig, and tension on the repaired supraspinatus was measured.

Results

X-rays showed that abduction of the glenohumeral joint with a sling was only 4°, with a sling with a small pillow was 13°, and with a sling with a large abduction pillow was 25°. Placing the cadaveric shoulders in the position of a sling with a small abduction pillow caused a reduction in tension on the supraspinatus of 27% anteriorly and 55% posteriorly compared to placing the shoulder in the position of a sling without an abduction pillow; a large abduction pillow caused a further reduction in tension, of 42% anteriorly and 56% posteriorly.

Conclusion

These findings show that abduction pillows reduce tension on the repaired supraspinatus tendon.

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Funding

The researchers received internal department funds from the Orthopaedic Research Institute, St. George Hospital, University of New South Wales, Sydney, Australia.

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Authors and Affiliations

  1. Orthopaedic Research Institute, St. George Hospital, University of New South Wales, 4-10 South Street, Kogarah, Sydney, NSW, 2217, Australia

    Jacqueline R. Hawthorne MD, Elise M. Carpenter MD, Patrick H. Lam PhD & George A. C. Murrell MD, DPhil

Authors
  1. Jacqueline R. Hawthorne MD
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  2. Elise M. Carpenter MD
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  3. Patrick H. Lam PhD
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  4. George A. C. Murrell MD, DPhil
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Corresponding author

Correspondence to George A. C. Murrell MD, DPhil.

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Conflict of Interest

Jacqueline R. Hawthorne, MD; Elise M. Carpenter, MD; and Patrick H. Lam, PhD, report that they have no conflict of interest. George A.C. Murrell, MD, DPhil, reports receiving grant support and fees as a consultant from ArthroCare Corporation.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

Informed Consent

Informed consent was waived from all patients for being included in this study.

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Disclosure forms provided by the authors are available with the online version of this article.

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Hawthorne, J.R., Carpenter, E.M., Lam, P.H. et al. Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis. HSS Jrnl 14, 114–122 (2018). https://doi.org/10.1007/s11420-017-9592-2

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  • DOI: https://doi.org/10.1007/s11420-017-9592-2

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