Clin Should Elbow.  2018 Jun;21(2):59-66. 10.5397/cise.2018.21.2.59.

Clinical and Radiological Results after Arthroscopic Superior Capsular Reconstruction in Patients with Massive Irreparable Rotator Cuff Tears

• Yoon JY
• Kim PS
• Jo CH

• KMID: 2436386
• DOI: http://doi.org/10.5397/cise.2018.21.2.59

Abstract

BACKGROUND
Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature.
METHODS
Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray.
RESULTS
All patients were men, and the average age was 59.5 ± 4.18 years (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was 27.33 ± 7.58 months (range, 18-36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR.
CONCLUSIONS
Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

Keyword

Superior capsular reconstruction; Rotator cuff tear; Dermal allograft; Autogenous fascia lata graft

MeSH Terms

Allografts
California
Classification
Elbow
Fascia Lata
Follow-Up Studies
Humans
Male
Range of Motion, Articular
Rotator Cuff*
Shoulder
Shoulder Pain
Surgeons
Tears*
Transplants