Micah Sommer1, Eric Wagner2, Sophie Zhu3, Sheila McRae1, Peter McDonald1, Dan Ogborn4, Jarret Woodmass5. 1. Pan Am Clinic Winnipeg, Manitoba, Canada; Department of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada. 2. Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia, United States of America. 3. Department of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada. 4. Pan Am Clinic Winnipeg, Manitoba, Canada. 5. Pan Am Clinic Winnipeg, Manitoba, Canada; Department of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: jwoodmass@panamclinic.com.
Abstract
PURPOSE: The purpose of this systematic review is to characterize the complications associated with Superior Capsule Reconstruction (SCR) for the treatment of Functionally Irreparable Rotator Cuff Tears (FIRCTs). METHODS: This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent reviewers completed a search of PubMed, Embase and Medline databases. Studies were deemed eligible for inclusion if they reported post-operative outcomes of arthroscopic SCR for FIRCTs and considered at least one post-operative complication. Statistical heterogeneity was quantified via the I2 statistic. Due to marked heterogeneity, pooled proportions were not reported. All complications and patient-reported outcomes were described qualitatively. RESULTS: 14 studies met the inclusion/exclusion criteria. The overall complication rate post SCR ranged from 5.0%-70.0% (I2 = 84.9%). Image verified graft re-tear ranged from 8%-70%, I2 = 79.4%) with higher rates reported when SCR was performed using allograft (19%-70%, I2 76.6%) compared to autograft (8%-29%, I2 = 66.1%). Reoperation (0%-36%, I2 = 73.4%), revision surgeries (0%-21%, I2 = 81.2%), medical complications (0%-5%, I2 = 0.0%) and infections (0%-5%, I2 = 0.0%) were also calculated. CONCLUSION: SCR carries a distinct complication profile when used for the treatment of FIRCTs. The overall rate of complications ranged from 5.0%-70.0%. The most common complication is graft retear with higher ranges in allografts (19%-70%) compared to autografts (8%-29%). The majority of studies reported at least one reoperation (range: 0-36%), most commonly for revision to reverse shoulder arthroplasty.
PURPOSE: The purpose of this systematic review is to characterize the complications associated with Superior Capsule Reconstruction (SCR) for the treatment of Functionally Irreparable Rotator Cuff Tears (FIRCTs). METHODS: This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent reviewers completed a search of PubMed, Embase and Medline databases. Studies were deemed eligible for inclusion if they reported post-operative outcomes of arthroscopic SCR for FIRCTs and considered at least one post-operative complication. Statistical heterogeneity was quantified via the I2 statistic. Due to marked heterogeneity, pooled proportions were not reported. All complications and patient-reported outcomes were described qualitatively. RESULTS: 14 studies met the inclusion/exclusion criteria. The overall complication rate post SCR ranged from 5.0%-70.0% (I2 = 84.9%). Image verified graft re-tear ranged from 8%-70%, I2 = 79.4%) with higher rates reported when SCR was performed using allograft (19%-70%, I2 76.6%) compared to autograft (8%-29%, I2 = 66.1%). Reoperation (0%-36%, I2 = 73.4%), revision surgeries (0%-21%, I2 = 81.2%), medical complications (0%-5%, I2 = 0.0%) and infections (0%-5%, I2 = 0.0%) were also calculated. CONCLUSION: SCR carries a distinct complication profile when used for the treatment of FIRCTs. The overall rate of complications ranged from 5.0%-70.0%. The most common complication is graft retear with higher ranges in allografts (19%-70%) compared to autografts (8%-29%). The majority of studies reported at least one reoperation (range: 0-36%), most commonly for revision to reverse shoulder arthroplasty.