Arthroscopic superior capsular reconstruction versus reverse shoulder arthroplasty in patients with massive irreparable rotator cuff tears: A comparative clinical study

Abstract

Objective: This study aimed to compare the clinical and functional outcomes of reverse shoulder arthroplasty versus arthroscopic superior capsular reconstruction in the treatment of patients with massive irreparable rotator cuff tears and Hamada grade 1-2 glenohumeral arthritis. Methods: It is a retrospective case–control study comparing the prospective results of 2 different treatment methods. This retrospective comparison of groups was conducted between May 2016 and May 2020. The study included 40 people with massive irreparable rotator cuff tear and Hamada grade 1-2 arthropathy who had arthroscopic superior capsular reconstruction with tensor fascia latae autograft or reverse shoulder arthroplasty surgery. Patients were divided into 2 groups according to treatment. Clinical outcome measures included shoulder range of motion, pain, and functional scores (Constant–Murley, American Shoulder and Elbow Surgeons). Results: The mean age was 61.85 ± 7.56 and 71.10 ± 6.42 years, respectively, for group I [superior capsular reconstruction (n = 20)] and group II [superior capsular reconstruction (n = 20)]. The mean follow-up was 22.30 ± 8.4 and 32.50 ± 8.11 months, respectively. In the postoperative data, flexion degrees and Constant scores were significantly higher in the superior capsular reconstruction group ( P = .007, P = .043). No significant difference was found between the 2 groups in all parameters ( P > .05) except abduction. The increase in abduction value in the reverse shoulder arthroplasty group was significantly higher than in the superior capsular reconstruction group ( P = .003). In addition, postoperative data in all parameters in both groups showed significant changes compared to preoperatively. Conclusion: This study has shown that superior capsular reconstruction with tensor fascia latae autograft can provide clinical and functional improvement similar to the reverse shoulder arthroplasty procedure in treating massive irreparable rotator cuff tears with Hamada grade 1-2 arthropathy. Level of Evidence: Level III, Therapeutic Study.