Superior capsular reconstruction (SCR) is a novel technique for treating irreparable rotator cuff tears in younger patients in whom a reverse total shoulder arthroplasty is not the optimal treatment choice. This case study describes a middle-aged male with a recurrent, massive, irreparable rotator cuff tear treated with SCR that subsequently failed at the glenoid attachment. The patient underwent successful arthroscopic revision of the SCR. The case illustrates the MRI and arthroscopic correlations of the failed dermal allograft reconstruction, which to our knowledge has not been previously shown in the radiology literature.
We evaluated interference screw fixation in a plug-tunnel construct using bioabsorbable screws as void fillers with different percentages of the screw removed. Nine-millimeter tunnels in a closed-cell foam block were filled with a 10-mm bioabsorbable screw, and 10-mm revision tunnels were placed in parallel with tunnel overlap resulting in removal of 10%, 25%, or 50% of the screw diameter. Synthetic bone plugs were fashioned to fit 10-mm tunnels. In all groups, the plugs were secured in standard interference fixation with a 9-mm metal screw between the void-filling bioabsorbable screw and plug. Failure loads for the control group (no revision tunnel) averaged 926 AE 44 N, 10% (1024 AE 129 N) and 25% (932 AE 129 N) groups were not significantly different; failure load in the 50% diameter group (780 AE 72 N) was significantly lower than all other groups (p < 0.001). Using a bioabsorbable screw as void filler provided mean load to failure not different from that of standard reconstruction when 10 and 25% of the diameter of the void-filling screw was removed. Load to failure was significantly lower when 50% of the void-filling screw diameter group was removed. This may be applicable in anterior cruciate ligament reconstruction where a previous tunnel void has to be addressed.
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