BACKGROUND: Arthroscopic superior capsule reconstruction was developed to restore superior stability, muscle balance, and function in the shoulder joint after an irreparable rotator cuff tear. Our objective was to assess the functional and radiographic results of superior capsule reconstruction after 5 years of follow-up. METHODS: Thirty patients who underwent arthroscopic superior capsule reconstruction using fascia lata autograft were enrolled in this study. The inclusion criteria were an irreparable rotator cuff tear confirmed by shoulder arthroscopy and 5 years of postoperative follow-up. Shoulder range of motion, American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) scores, rates of return to sport and physical work, acromiohumeral distance, Goutallier grade of all rotator cuff muscles, graft healing and thickness, and postoperative cuff tear arthropathy were investigated. RESULTS: Compared with preoperative values, ASES and JOA scores, active elevation, and acromiohumeral distance increased postoperatively at both 1 year (p < 0.001) and 5 years (p < 0.001); the 1-year values increased by 54.0 points for the ASES score, 34.4 points for the JOA score, 53° for active elevation, and 5.7 mm for acromiohumeral distance, and the 5-year values increased by 63.3 points for the ASES score, 39.9 points for the JOA score, 66° for active elevation, and 4.7 mm for acromiohumeral distance. The ASES score was greater at 5 years postoperatively than it was at 1 year postoperatively (mean difference, 9.3 points; p = 0.03). At 5 years postoperatively, 11 of 12 patients returned to physical work, a rate of 92% (95% confidence interval [CI], 73% to 100%), and 8 of 8 patients returned to sports, a rate of 100% (95% CI, 79% to 100%). None of the 27 patients who had graft healing showed progression of cuff tear arthropathy, but all 3 patients with a graft tear (10% [95% CI, 0% to 22%]) had severe cuff tear arthropathy at 5 years postoperatively. In the 27 patients whose grafts remained intact, the graft thicknesses at 3 months, 1 year, and 5 years postoperatively did not differ (p = 0.67). CONCLUSIONS: In this 5-year follow-up study, healed arthroscopic superior capsule reconstruction restored shoulder function and resulted in high rates of return to recreational sport and work. In patients with postoperative graft failure, severe cuff tear arthropathy was present at 5 years. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
BACKGROUND: Arthroscopic superior capsule reconstruction was developed to restore superior stability, muscle balance, and function in the shoulder joint after an irreparable rotator cuff tear. Our objective was to assess the functional and radiographic results of superior capsule reconstruction after 5 years of follow-up. METHODS: Thirty patients who underwent arthroscopic superior capsule reconstruction using fascia lata autograft were enrolled in this study. The inclusion criteria were an irreparable rotator cuff tear confirmed by shoulder arthroscopy and 5 years of postoperative follow-up. Shoulder range of motion, American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) scores, rates of return to sport and physical work, acromiohumeral distance, Goutallier grade of all rotator cuff muscles, graft healing and thickness, and postoperative cuff tear arthropathy were investigated. RESULTS: Compared with preoperative values, ASES and JOA scores, active elevation, and acromiohumeral distance increased postoperatively at both 1 year (p < 0.001) and 5 years (p < 0.001); the 1-year values increased by 54.0 points for the ASES score, 34.4 points for the JOA score, 53° for active elevation, and 5.7 mm for acromiohumeral distance, and the 5-year values increased by 63.3 points for the ASES score, 39.9 points for the JOA score, 66° for active elevation, and 4.7 mm for acromiohumeral distance. The ASES score was greater at 5 years postoperatively than it was at 1 year postoperatively (mean difference, 9.3 points; p = 0.03). At 5 years postoperatively, 11 of 12 patients returned to physical work, a rate of 92% (95% confidence interval [CI], 73% to 100%), and 8 of 8 patients returned to sports, a rate of 100% (95% CI, 79% to 100%). None of the 27 patients who had graft healing showed progression of cuff tear arthropathy, but all 3 patients with a graft tear (10% [95% CI, 0% to 22%]) had severe cuff tear arthropathy at 5 years postoperatively. In the 27 patients whose grafts remained intact, the graft thicknesses at 3 months, 1 year, and 5 years postoperatively did not differ (p = 0.67). CONCLUSIONS: In this 5-year follow-up study, healed arthroscopic superior capsule reconstruction restored shoulder function and resulted in high rates of return to recreational sport and work. In patients with postoperative graft failure, severe cuff tear arthropathy was present at 5 years. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Authors: David Kovacevic; Robert J Suriani; Brian M Grawe; Edward H Yian; Mohit N Gilotra; S Ashfaq Hasan; Umasuthan Srikumaran; Samer S Hasan; Frances Cuomo; Robert T Burks; Andrew G Green; Wesley M Nottage; Sai Theja; Hafiz F Kassam; Maarouf A Saad; Miguel A Ramirez; Rodney J Stanley; Matthew D Williams; Vidushan Nadarajah; Alexis C Konja; Jason L Koh; Andrew S Rokito; Charles M Jobin; William N Levine; Christopher C Schmidt Journal: J Shoulder Elbow Surg Date: 2020-08-04 Impact factor: 3.019
Authors: Jonathan D Hughes; Brian Davis; Emily Whicker; Gregory R Sprowls; Lindsay Barrera; Ashkan Baradaran; Soheil Sabzevari; Jeremy M Burnham; Anup A Shah; Albert Lin Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-08-16 Impact factor: 4.114
Authors: Patrick J Denard; Seungbum Chae; Christen Chalmers; Jae Hyuk Choi; Michelle H McGarry; Gregory Adamson; Max Park; Thay Q Lee Journal: Arthrosc Sports Med Rehabil Date: 2021-01-30
Authors: Clara Isabel de Campos Azevedo; Ana Catarina Leiria Pires Gago Ângelo; Carlos Quental; Sérgio Gonçalves; João Folgado; Nuno Ferreira; Nuno Sevivas Journal: JSES Int Date: 2021-03-29
Authors: Samuel E Broida; Aidan P Sweeney; Michael B Gottschalk; Jarret M Woodmass; Eric R Wagner Journal: Eur J Orthop Surg Traumatol Date: 2021-08-09