Arthroscopic superior capsular reconstruction with dermal allograft for primary and recurrent rotator cuff tears

© 2023 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 7(2023), 4 vom: 01. Juli, Seite 574-580
1. Verfasser: Thangarajah, Tanujan (VerfasserIn)
Weitere Verfasser: Tsuchiya, Saho, Lukenchuk, Jayd, Lo, Ian K
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2023
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Allograft Revision surgery Rotator cuff repair Rotator cuff retear Rotator cuff tear Superior capsular reconstruction
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245 1 0 |a Arthroscopic superior capsular reconstruction with dermal allograft for primary and recurrent rotator cuff tears 
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520 |a Background: The aim of this study was to compare the clinical outcomes and retear rate of arthroscopic superior capsular reconstruction (SCR) with dermal allograft following structural failure of a previous rotator cuff repair, with a cohort of primary SCRs 
520 |a Methods: This was a retrospective comparative study with a study group comprising 22 patients who were followed up at a minimum of 24 (mean, 41; range, 27-65) months after SCR with dermal allograft performed for structural failure of a previous rotator cuff repair. The control group included 13 patients who previously underwent a primary SCR using dermal allograft and were followed up for 24 months. Clinical outcome measures comprised range of motion, the American Shoulder and Elbow Surgeons score, and the Western Ontario Rotator Cuff (WORC) Index. Radiological outcomes included the acromiohumeral interval and graft integrity on magnetic resonance imaging at one year. Logistic regression was used to determine whether SCR being undertaken as either a primary or revision procedure influenced functional outcomes or retear rate 
520 |a Results: The mean age at the time of surgery was 58 (range, 39-74) years for the study group and 60 (range, 48-70) years for the control group. Forward flexion improved from a mean of 117° (range, 7°-180°) preoperatively to 140° (range, 45°-170°) postoperatively (P = .11), and external rotation increased from a mean of 31° (range, 0°-70°) preoperatively to 36° (range, 0°-60°) postoperatively (P = .23). The American Shoulder and Elbow Surgeons score improved (P = 0) from a mean of 38 (range, 12-68) to 73 (range, 17-95), and the WORC Index improved (P = 0) from a mean of 29 (range, 7-58) to 59 (range, 30-97). Following SCR, there was no significant change in the acromiohumeral interval. The graft was intact in 42% of cases on magnetic resonance imaging and none of the retears underwent further surgery. Compared to revision SCR, primary SCR resulted in a significant improvement in forward flexion (P = .001), external rotation (P = 0), and WORC Index (P = .019). Logistic regression demonstrated that SCR performed as a revision procedure was associated with a higher retear rate (P = .006) and worse forward flexion (P = .009) and external rotation (P = .008) 
520 |a Conclusion: SCR using human dermal allograft following structural failure of a previous rotator cuff repair can lead to an improvement in clinical outcomes but the results are inferior to primary procedures 
650 4 |a Journal Article 
650 4 |a Allograft 
650 4 |a Revision surgery 
650 4 |a Rotator cuff repair 
650 4 |a Rotator cuff retear 
650 4 |a Rotator cuff tear 
650 4 |a Superior capsular reconstruction 
700 1 |a Tsuchiya, Saho  |e verfasserin  |4 aut 
700 1 |a Lukenchuk, Jayd  |e verfasserin  |4 aut 
700 1 |a Lo, Ian K  |e verfasserin  |4 aut 
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