Superior Capsule Reconstruction: A Glimpse into the Future?
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EVIDENCE BASED REVIEW IN ORTHOPEDICS
Superior Capsule Reconstruction: A Glimpse into the Future? Ryan R. Thacher, MD
& Braiden
R. Heaps, MD & Joshua S. Dines, MD
Received: 1 March 2020/Accepted: 20 August 2020 * Hospital for Special Surgery 2020
Abstract The recent study by Mihata et al., [10] “Fiveyear follow-up of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears” (J Bone Joint Surg Am. 2019;101:1921–1930), was the first case series published examining long-term clinical and radiographic outcomes of superior capsule reconstruction (SCR) for irreparable rotator cuff tears. This article is a critical review of how the aforementioned study fits into a growing literature surrounding the use of SCR for irreparable rotator cuff tears and how these results may impact clinical and operative decision-making for this patient population. The series compares clinical and radiographic data taken preoperatively with data taken at 1 year and 5 years postoperatively in a group of 30 patients who underwent SCR utilizing tensor fascia lata autograft. While the results of the study suggest that a healed SCR graft utilizing this specific technique successfully restored shoulder function and prevented progression of rotator cuff arthropathy, it is important to appreciate the limitations of this small, retrospective case series. Nonetheless, the study represents an important addition to the expanding literature surrounding this significant topic. In this report, we shed light on the current state of this novel operative technique and the ongoing controversies revolving around graft material and thickness. Keywords superior capsule reconstruction . rotator cuff tear . long-term outcomes
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09796-y) contains supplementary material, which is available to authorized users. R. R. Thacher, MD (*) : B. R. Heaps, MD : J. S. Dines, MD Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA e-mail: [email protected]
Introduction The treatment of massive and irreparable rotator cuff tears continues to be a challenge for orthopedic surgeons. In the elderly population, reverse shoulder arthroplasty is a salvage procedure that has been shown to reliably provide pain relief and improve shoulder elevation [2, 5, 17, 21, 22]. However, the appropriate management of this condition in younger, more active patients with higher functional demands remains elusive [20]. The superior capsule reconstruction (SCR) was recently developed as a treatment option to restore shoulder function and reduce pain for patients with massive rotator cuff tears and has been hailed by some as a solution to this challenging condition [15]. In this technique, a graft, typically fascia lata autograft or dermal allograft, is introduced and secured to span from the superior aspect of the glenoid to the greater tuberosity. The graft resists superior translation of the humeral head, thus recreating superior shoulder stability wi
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