Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Yoon, Jeong Yong (Departments of Orthopedic Surgery, 1 Orthopedic Surgery and Translational Medicine, SMG-SNU Boramae Medical Center) ;
  • Kim, Paul Shinil (Departments of Orthopedic Surgery, 1 Orthopedic Surgery and Translational Medicine, SMG-SNU Boramae Medical Center) ;
  • Jo, Chris Hyunchul (Departments of Orthopedic Surgery, 1 Orthopedic Surgery and Translational Medicine, SMG-SNU Boramae Medical Center)
  • Received : 2018.03.19
  • Accepted : 2018.04.22
  • Published : 2018.06.01
Download PDF
⟨ Previous Next ⟩

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 $59.5{\pm}4.18years$ (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was $27.33{\pm}7.58months$ (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.

Keywords

References

  1. Rockwood CA Jr, Williams GR Jr, Burkhead WZ Jr. Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am. 1995;77(6):857-66. https://doi.org/10.2106/00004623-199506000-00006
  2. Chen KH, Chiang ER, Wang HY, Ma HL. Arthroscopic partial repair of irreparable rotator cuff tears: factors related to greater degree of clinical improvement at 2 years of follow-up. Arthroscopy. 2017;33(11):1949-55.
  3. Burkhart SS, Nottage WM, Ogilvie-Harris DJ, Kohn HS, Pachelli A. Partial repair of irreparable rotator cuff tears. Arthroscopy. 1994;10(4):363-70. https://doi.org/10.1016/S0749-8063(05)80186-0
  4. Gerber C, Rahm SA, Catanzaro S, Farshad M, Moor BK. Latissimus dorsi tendon transfer for treatment of irreparable posterosuperior rotator cuff tears: long-term results at a minimum follow-up of ten years. J Bone Joint Surg Am. 2013;95(21):1920-6. https://doi.org/10.2106/JBJS.M.00122
  5. Grimberg J, Kany J, Valenti P, Amaravathi R, Ramalingam AT. Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears. Arthroscopy. 2015;31(4):599-607.e1. https://doi.org/10.1016/j.arthro.2014.10.005
  6. Gavriilidis I, Kircher J, Magosch P, Lichtenberg S, Habermeyer P. Pectoralis major transfer for the treatment of irreparable anterosuperior rotator cuff tears. Int Orthop. 2010;34(5):689-94. https://doi.org/10.1007/s00264-009-0799-9
  7. Bond JL, Dopirak RM, Higgins J, Burns J, Snyder SJ. Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results. Arthroscopy. 2008;24(4):403-9.e1.
  8. Mori D, Funakoshi N, Yamashita F. Arthroscopic surgery of irreparable large or massive rotator cuff tears with lowgrade fatty degeneration of the infraspinatus: patch autograft procedure versus partial repair procedure. Arthroscopy. 2013;29(12):1911-21. https://doi.org/10.1016/j.arthro.2013.08.032
  9. Senekovic V, Poberaj B, Kovacic L, Mikek M, Adar E, Dekel A. Prospective clinical study of a novel biodegradable subacromial spacer in treatment of massive irreparable rotator cuff tears. Eur J Orthop Surg Traumatol. 2013;23(3):311-6. https://doi.org/10.1007/s00590-012-0981-4
  10. Senekovic V, Poberaj B, Kovacic L, et al. The biodegradable spacer as a novel treatment modality for massive rotator cuff tears: a prospective study with 5-year follow-up. Arch Orthop Trauma Surg. 2017;137(1):95-103. https://doi.org/10.1007/s00402-016-2603-9
  11. Ramirez MA, Ramirez J, Murthi AM. Reverse total shoulder arthroplasty for irreparable rotator cuff tears and cuff tear arthropathy. Clin Sports Med. 2012;31(4):749-59. https://doi.org/10.1016/j.csm.2012.07.009
  12. Cuff D, Clark R, Pupello D, Frankle M. Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency: a concise follow-up, at a minimum of five years, of a previous report. J Bone Joint Surg Am. 2012;94(21):1996-2000. https://doi.org/10.2106/JBJS.K.01206
  13. Galasso O, Familiari F, Gasparini G. Treatment options for irreparable postero-superior cuff tears in young patients. World J Orthop. 2015;6(10):770-5. https://doi.org/10.5312/wjo.v6.i10.770
  14. Mihata T, McGarry MH, Pirolo JM, Kinoshita M, Lee TQ. Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: a biomechanical cadaveric study. Am J Sports Med. 2012;40(10):2248-55. https://doi.org/10.1177/0363546512456195
  15. Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29(3):459-70. https://doi.org/10.1016/j.arthro.2012.10.022
  16. Denard PJ, Brady PC, Adams CR, Tokish JM, Burkhart SS. Preliminary results of arthroscopic superior capsule reconstruction with dermal allograft. Arthroscopy. 2018;34(1):93-9. https://doi.org/10.1016/j.arthro.2017.08.265
  17. Hirahara AM, Andersen WJ, Panero AJ. Superior capsular reconstruction: clinical outcomes after minimum 2-year followup. Am J Orthop (Belle Mead NJ). 2017;46(6):266-78.
  18. Tokish JM, Beicker C. Superior capsule reconstruction technique using an acellular dermal allograft. Arthrosc Tech. 2015;4(6):e833-9. https://doi.org/10.1016/j.eats.2015.08.005
  19. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8(6):599-605. https://doi.org/10.1016/S1058-2746(99)90097-6
  20. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;(254):92-6.
  21. Gerber C, Wirth SH, Farshad M. Treatment options for massive rotator cuff tears. J Shoulder Elbow Surg. 2011;20(2 Suppl):S20-9. https://doi.org/10.1016/j.jse.2010.11.028
  22. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;(304):78-83.
  23. Goutallier D, Le Guilloux P, Postel JM, Radier C, Bernageau J, Zilber S. Acromio humeral distance less than six millimeter: its meaning in full-thickness rotator cuff tear. Orthop Traumatol Surg Res. 2011;97(3):246-51. https://doi.org/10.1016/j.otsr.2011.01.010
  24. Jo CH, Yoon KS, Lee JH, et al. The effect of multiple channeling on the structural integrity of repaired rotator cuff. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2098-107. https://doi.org/10.1007/s00167-011-1520-2
  25. Pfirrmann CW, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology. 1999;213(3):709-14. https://doi.org/10.1148/radiology.213.3.r99dc03709
  26. Mihata T, McGarry MH, Kahn T, Goldberg I, Neo M, Lee TQ. Biomechanical effect of thickness and tension of fascia lata graft on glenohumeral stability for superior capsule reconstruction in irreparable supraspinatus tears. Arthroscopy. 2016;32(3):418-26. https://doi.org/10.1016/j.arthro.2015.08.024
  27. Chang SK, Egami DK, Shaieb MD, Kan DM, Richardson AB. Anterior cruciate ligament reconstruction: allograft versus autograft. Arthroscopy. 2003;19(5):453-62. https://doi.org/10.1053/jars.2003.50103

Cited by

  1. Comparison Between Autografts and Allografts in Superior Capsular Reconstruction: A Systematic Review of Outcomes vol.8, pp.3, 2020, https://doi.org/10.1177/2325967120904937
  2. Arthroscopic Superior Capsular Reconstruction With Mesh Augmentation for the Treatment of Irreparable Rotator Cuff Tears: A Comparative Study of Surgical Outcomes vol.48, pp.13, 2018, https://doi.org/10.1177/0363546520958708
  3. Failure Rate After Superior Capsular Reconstruction With Achilles Tendon-Bone Allograft for Irreparable Rotator Cuff Tears vol.9, pp.5, 2018, https://doi.org/10.1177/23259671211002280
  4. The best options in superior capsular reconstruction vol.24, pp.2, 2018, https://doi.org/10.5397/cise.2021.00136
  5. Arthroscopic Superior Capsular Reconstruction for Older Patients With Irreparable Rotator Cuff Tears: A Comparative Study With Younger Patients vol.49, pp.10, 2018, https://doi.org/10.1177/03635465211024652