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. 2023 Jul 28;11(7):23259671231185182.
doi: 10.1177/23259671231185182. eCollection 2023 Jul.

Comparison of Outcomes After Arthroscopic Superior Capsule Reconstruction Versus Arthroscopic Partial Repair or Arthroscopic Debridement for Irreparable Rotator Cuff Tears

Jakob E Schanda  1   2 , Martin Eigenschink  1   3 , Brenda Laky  3   4 , Julia K Frank  5 , Leo Pauzenberger  5   6 , Werner Anderl  4 , Philipp R Heuberer  3   6
Affiliations

Comparison of Outcomes After Arthroscopic Superior Capsule Reconstruction Versus Arthroscopic Partial Repair or Arthroscopic Debridement for Irreparable Rotator Cuff Tears

Jakob E Schanda et al. Orthop J Sports Med. .

Abstract

Background: Arthroscopic superior capsule reconstruction (SCR), arthroscopic partial repair (PR), and arthroscopic debridement (DB) are valid treatment options for irreparable rotator cuff (RC) tears.

Purpose/hypothesis: The purpose of this study was to compare clinical, functional, and radiological outcomes of arthroscopic SCR with arthroscopic PR and arthroscopic DB in patients with irreparable posterosuperior RC tears. It was hypothesized that SCR would lead to superior clinical and functional outcomes compared with PR or DB.

Study design: Cohort study; Level of evidence, 3.

Methods: Clinical and functional outcomes of this single-center retrospective study included range of motion, strength, and the age- and sex-adjusted Constant-Murley score. Patient-reported outcome measures (PROMs) involved the quick Disabilities of the Arm, Shoulder and Hand score, the Subjective Shoulder Value, and the visual analog scale for pain. Graft and repaired tendon integrity was evaluated by magnetic resonance imaging (MRI) at 12 months of follow-up.

Results: In total, 57 patients treated with SCR (n = 20), PR (n = 17), and DB (n = 20) were included. The mean clinical follow-up was 33.8 ± 17.9 months. Preoperative clinical and functional characteristics were comparable among the 3 groups. The range of motion and clinical and functional scores of all 3 groups significantly improved from pre- to postoperatively. Postoperative PROMs showed no differences among all 3 study groups. SCR revealed significantly higher postoperative strength compared with PR (P = .001) and DB (P = .004). Postoperative MRI revealed a rerupture in 4 patients with SCR (20%). Postoperative MRI showed a rerupture in 9 patients with PR ( 53%). Fatty muscle infiltration of the supraspinatus and infraspinatus significantly progressed within all 3 study groups in postoperative MRI scans. No clinical and functional differences were observed between intact and reruptured PR.

Conclusion: Patients who underwent SCR had better postoperative strength recovery than patients who underwent PR or DB.

Keywords: SCR; arthroscopy; debridement; fatty muscle infiltration; irreparable rotator cuff tear; magnetic resonance imaging; partial repair; repair integrity; superior capsule reconstruction.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: W.A. has received consulting fees from Arthrex and royalties from Arthrex and Medacta. P.R.H. has received consulting fees from Shoulder Pacemaker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Subcategories of (A) preoperative and (B) postoperative age- and sex-adjusted Constant-Murley scores comparing arthroscopic superior capsule reconstruction (SCR) with arthroscopic partial repair (PR) and arthroscopic debridement (DB). Significant values are marked with brackets. Circles represent outliers, and stars represent extreme outliers.
See this image and copyright information in PMC

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