Superior Capsular Reconstruction: Clinical Outcomes After Minimum 2-Year Follow-Up

Alan M. Hirahara, Wyatt J. Andersen, Alberto J. Panero

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Superior capsular reconstruction (SCR) is performed to reduce the pain and disability caused by irreparable supraspinatus rotator cuff tears (RCTs). In this article, we discuss 9 cases of irreparable rotator cuff tears managed with arthroscopic SCR with dermal allograft. At minimum 2-year follow-up (mean, 32.38 months), the patients were prospectively evaluated on the American Shoulder and Elbow Surgeons (ASES) shoulder index, a visual analog scale (VAS) for pain, acromial-humeral distance, and ultrasonography. Patients were compared before and after surgery and against historical controls who underwent repair of massive RCTs. From before surgery to 2 years after surgery, mean ASES score improved significantly (P < .00002), from 43.54 to 86.46, and mean VAS pain score decreased significantly (P < .00002), from 6.25 to 0.38. For the historical controls at final follow-up, mean ASES score was 70.71 (P = .11), and mean VAS pain score was 3.00 (P < .05). Mean acromial-humeral distance improved from 4.50 mm before surgery to 8.48 mm immediately after surgery (P < .0008) and 7.60 mm 2 years after surgery (P < .05). Ultrasonography revealed pulsatile vessels within the allograft tissue between 4 and 8 months after surgery. One patient underwent reverse total shoulder arthroplasty (RTSA) for anterior escape; another had the graft rupture after a motor vehicle accident. Our data showed SCR with dermal allograft effectively restored the superior restraints in the glenohumeral joint and yielded outstanding clinical outcomes even after 2 years, making it an excellent viable alternative to RTSA.

Original languageEnglish (US)
Pages (from-to)266-278
Number of pages13
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume46
Issue number6
StatePublished - Nov 1 2017

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Pain Measurement
Elbow
Allografts
Arthroplasty
Ultrasonography
Skin
Shoulder Joint
Rotator Cuff
Motor Vehicles
Accidents
Rupture
Transplants
Pain
Rotator Cuff Injuries
Surgeons

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Superior Capsular Reconstruction : Clinical Outcomes After Minimum 2-Year Follow-Up. / Hirahara, Alan M.; Andersen, Wyatt J.; Panero, Alberto J.

In: American journal of orthopedics (Belle Mead, N.J.), Vol. 46, No. 6, 01.11.2017, p. 266-278.

Research output: Contribution to journalArticle

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