20th ESSKA Congress, Paris, Fransa, 27 Nisan 2022, cilt.1, ss.1040
Objectives: Several treatment options are available for stable massive rotator cuff tears including partial repair with or without tissue augmentation, tendon transfer, superior capsular reconstruction (SCR), and reverse shoulder arthroplasty. The purpose of this study was to compare the outcomes and effectiveness of partial rotator cuff repair with superior capsular reconstruction using the long head of the biceps tendon (PRCR-SCRB) and superior capsular reconstruction with tensor fascia lata autograft (SCRTF) for the treatment of rotator cuff tear with severe fatty degeneration. The hypothesis of this study was that SCRTF is superior to PRCR-SCRB in functional and anatomical outcomes.
Methods: 36 consecutive patients with massive and fatty degenerative rotator cuff tears were surgically treated. The patients were divided into those who underwent partial rotator cuff repair with superior capsular reconstruction using the long head of the biceps tendon (20 patients, group 1) and those who underwent superior capsular reconstruction with autogenic tensor fascia lata graft (16 patients, group 2). Functional outcome was assessed at final follow-up, and acromiohumeral distance (AHD) was measured.
Results: All functional scores significantly improved in both groups at final follow-up. PRCR-SCRB group showed better overall outcomes in terms of visual analog scale for pain, American shoulder and elbow surgeons score, and quick disabilities of the arm, shoulder, and hand score, but these differences were not statistically significant. It only showed statistically significantly better outcomes in terms of AHD (p<0.04). However, no statistical difference was found in terms of re-operation rates
Conclusions: PRCR-SCB had comparable outcomes and improvement in AHD as superior capsular reconstruction with SCRTF without the need for additional graft harvesting.