TY - JOUR
T1 - Prospective 1-Year Outcomes Are Maintained at Short-Term Final Follow-Up After Superior Capsular Reconstruction Augmentation of Complete Rotator Cuff Repair
AU - Degan, Timothy J.
AU - Hartzler, Robert U.
AU - Rahal, Andres
AU - DeBerardino, Thomas M.
AU - Burkhart, Stephen S.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: T.J.D. receives grants from Arthrex , outside the submitted work, and personal fees from Arthrex , Aesculap/Braun, and Musculoskeletal Transplant Foundation , outside the submitted work. R.U.H. is consultant for Stryker , outside the submitted work, and receives textbook publishing royalties from Wolters Kluwer Health–Lippincott Williams & Wilkins. S.S.B. is a consultant for Arthrex , outside the submitted work; receives royalties from Arthrex , outside the submitted work; has patents pending (US20170105716A1 and US20170189007A1); and receives textbook royalties from Wolters Kluwer Health–Lippincott Williams & Wilkins. Full ICMJE author disclosure forms are available for this article online, as supplementary material .
Funding Information:
The authors report the following potential conflicts of interest or sources of funding: T.J.D. receives grants from Arthrex, outside the submitted work, and personal fees from Arthrex, Aesculap/Braun, and Musculoskeletal Transplant Foundation, outside the submitted work. R.U.H. is consultant for Stryker, outside the submitted work, and receives textbook publishing royalties from Wolters Kluwer Health–Lippincott Williams & Wilkins. S.S.B. is a consultant for Arthrex, outside the submitted work; receives royalties from Arthrex, outside the submitted work; has patents pending (US20170105716A1 and US20170189007A1); and receives textbook royalties from Wolters Kluwer Health–Lippincott Williams & Wilkins. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2021 Arthroscopy Association of North America
PY - 2022/5
Y1 - 2022/5
N2 - Purpose: To evaluate the outcomes of arthroscopic superior capsular reconstruction (SCR) augmentation of complete, massive rotator cuff repair (RCR). Methods: A retrospective study of dermal allograft SCR-augmented RCRs performed by a single surgeon from June 2016 through December 2017 was performed with the following inclusion criteria: massive rotator cuff tear amenable to complete repair but with poor-quality native rotator cuff tissue. Radiographic follow-up was performed at 1 year, and clinical follow-up was performed at both 1 year and a minimum 2 years after surgery. Clinical follow-up included the American Shoulder and Elbow Surgeons score, visual analog scale score for pain, Subjective Shoulder Value score, active forward elevation, and external rotation. Radiographs and magnetic resonance imaging (MRI) scans were assessed for muscle quality using the Goutallier classification, and graft and cuff integrity was assessed according to the Sugaya classification. Results: The inclusion criteria were met by 24 patients at 1 year and by 18 (75%) at a minimum of 2 years postoperatively. Patient-reported outcomes were improved compared with preoperative data and were maintained at minimum 2-year follow-up, with median American Shoulder and Elbow Surgeons scores of 42.5 (interquartile range [IQR], 30.8-58.7) versus 93.9 (IQR, 82.4-100) (P < .001); median Subjective Shoulder Value scores of 30 (IQR, 20-50) versus 90 (IQR, 86.2-97.2) (P < .001); and median visual analog scale pain scores of 5.5 (IQR, 1-9) versus 0 (IQR, 0-0.8) (P = .001). Evaluation of graft and tendon healing on postoperative MRI revealed poor interobserver agreement and showed 10 completely healed grafts (42%), 9 partially healed grafts (38%), and 5 completely disrupted grafts (21%), with 42% of supraspinatus tendons and 54% of infraspinatus tendons healed. Conclusions: SCR with dermal allograft augmentation of complete RCR with poor-quality tissue shows very good clinical outcomes at minimum 2-year follow-up. Poor interobserver agreement regarding postoperative graft and rotator cuff integrity by MRI was found. The healing rate for the SCR grafts was 79%. The rates of healing of the native supraspinatus and infraspinatus tendons were 42% and 54%, respectively. Level of Evidence: Level IV, retrospective case series.
AB - Purpose: To evaluate the outcomes of arthroscopic superior capsular reconstruction (SCR) augmentation of complete, massive rotator cuff repair (RCR). Methods: A retrospective study of dermal allograft SCR-augmented RCRs performed by a single surgeon from June 2016 through December 2017 was performed with the following inclusion criteria: massive rotator cuff tear amenable to complete repair but with poor-quality native rotator cuff tissue. Radiographic follow-up was performed at 1 year, and clinical follow-up was performed at both 1 year and a minimum 2 years after surgery. Clinical follow-up included the American Shoulder and Elbow Surgeons score, visual analog scale score for pain, Subjective Shoulder Value score, active forward elevation, and external rotation. Radiographs and magnetic resonance imaging (MRI) scans were assessed for muscle quality using the Goutallier classification, and graft and cuff integrity was assessed according to the Sugaya classification. Results: The inclusion criteria were met by 24 patients at 1 year and by 18 (75%) at a minimum of 2 years postoperatively. Patient-reported outcomes were improved compared with preoperative data and were maintained at minimum 2-year follow-up, with median American Shoulder and Elbow Surgeons scores of 42.5 (interquartile range [IQR], 30.8-58.7) versus 93.9 (IQR, 82.4-100) (P < .001); median Subjective Shoulder Value scores of 30 (IQR, 20-50) versus 90 (IQR, 86.2-97.2) (P < .001); and median visual analog scale pain scores of 5.5 (IQR, 1-9) versus 0 (IQR, 0-0.8) (P = .001). Evaluation of graft and tendon healing on postoperative MRI revealed poor interobserver agreement and showed 10 completely healed grafts (42%), 9 partially healed grafts (38%), and 5 completely disrupted grafts (21%), with 42% of supraspinatus tendons and 54% of infraspinatus tendons healed. Conclusions: SCR with dermal allograft augmentation of complete RCR with poor-quality tissue shows very good clinical outcomes at minimum 2-year follow-up. Poor interobserver agreement regarding postoperative graft and rotator cuff integrity by MRI was found. The healing rate for the SCR grafts was 79%. The rates of healing of the native supraspinatus and infraspinatus tendons were 42% and 54%, respectively. Level of Evidence: Level IV, retrospective case series.
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U2 - 10.1016/j.arthro.2021.11.008
DO - 10.1016/j.arthro.2021.11.008
M3 - Article
AN - SCOPUS:85121268836
VL - 38
SP - 1411
EP - 1419
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
SN - 0749-8063
IS - 5
ER -