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Clinical and Radiological Results after Arthroscopic Superior Capsular Reconstruction in Patients with Massive Irreparable Rotator Cuff Tears
Clinics in Shoulder and Elbow 2018;21:59-66
Published online June 1, 2018
© 2018 Korean Shoulder and Elbow Society.

Jeong Yong Yoon, Paul Shinil Kim, Chris Hyunchul Jo1

Departments of Orthopedic Surgery, 1Orthopedic Surgery and Translational Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
Correspondence to:
Chris Hyunchul Jo
Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea
Tel: +82-2-870-2315, Fax: +82-2-870-3864, E-mail: chrisjo@snu.ac.kr, ORCID: https://orcid.org/0000-0002-6161-5442
Received March 19, 2018; Revised April 20, 2018; Accepted April 22, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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 짹 4.18 years (range, 53–65 years).The minimum follow-up was 18 months with a mean follow-up was 27.33 짹 7.58 months (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.
(Clin Shoulder Elbow 2018;21(2):59-66)
Keywords : Superior capsular reconstruction; Rotator cuff tear; Dermal allograft; Autogenous fascia lata graft