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Anterior Capsule Reconstruction

  • Jonas PogorzelskiEmail author
  • Erik M. Fritz
  • Peter J. Millett
Chapter

Abstract

In patients with irreparable tears of the subscapularis tendon, reconstruction with an allo- or autograft may be a viable therapeutic option. However, the postoperative results of published techniques show varying rates of success. Using a human acellular dermal allograft for an anterior capsule reconstruction (ACR) may offer additional benefits such as superior mechanical strength compared to smaller and thinner tendon allografts used in the past. The implantation of an allograft replaces the torn subscapularis tendon’s role as the anterior joint stabilizer, thus preventing the humeral head from migrating anteriorly by acting as a static restraint. This surgery alters shoulder biomechanics as the graft acts as a static restraint, thereby centering the humeral head during active movement, preventing anterior escape, and thus leading to improved function and pain relief.

Keywords

Anterior capsule reconstruction Allograft Subscapularis tear 

Recommended Literature

  1. 1.
    Dewing CB, Horan MP, Millett PJ. Two-year outcomes of open shoulder anterior capsular reconstruction for instability from severe capsular deficiency. Arthroscopy. 2012;28:43–51.CrossRefGoogle Scholar
  2. 2.
    Millett PJ, Clavert P, Warner JJ. Open operative treatment for anterior shoulder instability: when and why? J Bone Joint Surg Am. 2005;87:419–32.PubMedGoogle Scholar
  3. 3.
    Pogorzelski J, Hussain ZB, Lebus GF, Fritz EM, Millett PJ. Anterior capsular reconstruction for irreparable subscapularis tears. Arthrosc Tech. 2017;6(4):e951–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jonas Pogorzelski
    • 1
    Email author
  • Erik M. Fritz
    • 2
  • Peter J. Millett
    • 3
  1. 1.Department of Orthopaedic Sports MedicineTechnical University of MunichMunichGermany
  2. 2.Department of Orthopaedic SurgeryUniversity of MinnesotaMinneapolisUSA
  3. 3.Shoulder, Knee, Elbow and Sports Medicine, Orthopaedic SurgeryThe Steadman ClinicVailUSA

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