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. 2021 May 14:19:62-66.
doi: 10.1016/j.jcot.2021.05.011. eCollection 2021 Aug.

Superior capsular reconstruction for irreparable rotator cuff tears: A literature review and specialist practice report

Aditya Prinja  1 , Hariharan Mohan  1 , Jagwant Singh  1 , Michael Walton  1 , Lennard Funk  1 , Puneet Monga  1
Affiliations

Superior capsular reconstruction for irreparable rotator cuff tears: A literature review and specialist practice report

Aditya Prinja et al. J Clin Orthop Trauma. .

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Jul 30;20:101538. doi: 10.1016/j.jcot.2021.101538. eCollection 2021 Sep. J Clin Orthop Trauma. 2021. PMID: 34405083 Free PMC article.

Abstract

Background: Recent evidence continues to confirm the effectiveness of arthroscopic superior capsular reconstruction (SCR) in relieving pain and improving function in an irreparable cuff deficient shoulder. This paper presents an up-to-date literature review on SCRand a tertiary referral unit experience in the United Kingdom.

Methods: Data was prospectively collected on patients undergoing SCR for irreparable rotator cuff tears using a dermal allograft. Patients with already established arthritis were excluded. The first 49 consecutive cases performed by 3 surgeons over 3 years (including their learning curve) with average follow-up of 19 months (range 3-37 months) were analysed. The outcomes assessed were re-operation rates, patient satisfaction and complications. The study group was analysed to identify the factors predicting outcomes.

Results: The average age of the cohort was 56 years. The re-operation rate in this group was 12.2% with each of these 6 patients subsequently undergoing a reverse total shoulder arthroplasty. Forty (82%) patients were satisfied with the outcome of the procedure with 35 (72%) of them showing complete pain relief, 5 (10%) having dull aches and clicks and the remaining 9 (18%) unsatisfied due to pain. There was no difference in satisfaction rates between different age groups (p > 0.05). The pre-operative factors associated with poor outcomes included patients with multiple previous surgeries on the same shoulder (p = 0.02) and teres minor atrophy or tear (p = 0.03). The other factors that showed a trend towards inferior outcomes (but not statistically significant) included patients with degenerative tears, symptoms of longer duration (>24 months) and subscapularis tear/atrophy. No serious adverse effects such as graft rejection, infection or neuro-vascular injury were observed.

Conclusion: Early results of superior capsular reconstruction are promising and may offer an answer to a challenging group of patients with symptomatic irreparable rotator cuff tears. It is likely that the relatively low re-operation rates can be further improved by considering the negative prognostic factors in defining indications for surgery.

Keywords: Arthroscopy; Rotator cuff; Shoulder; Superior capsular reconstruction.

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