Arthroscopic superior capsule reconstruction with Teflon felt synthetic graft for irreparable massive rotator cuff tears: clinical and radiographic results at minimum 2-year follow-up

Arthroscopic Superior Capsular Reconstruction for Massive Irreparable Rotator Cuff Tears Results in Significant Improvements in Patient Reported Outcomes and Range of Motion: A Systematic Review

“…FLA was used by folding into 2-3 layers with the final thickness of 5-8 mm in 5 studies, and only 1 study 32 performed the ASCR with 1-layer FLA. All HDA and PDX presented in 7 studies were 3 mm thick. In a study of synthetic graft, 33 a comparison of clinical outcomes of ASCR was conducted between 1-layer and 3-layer grafts. In addition, one of these studies reported the clinical outcomes of ASCR using FLA and FLA with artificial mesh augmentation.…”

“…As for the change of ROM at final follow-up, active forward flexion/elevation, active abduction, and active external rotation were characterized as clinical outcome measurements (Table 3). The mean improvements in active forward flexion/active elevation were reported in 11 studies 18,[31][32][33][34][35][36][37][38]40,41 (13 items), with a range improvement of 12 to 73.68 (in two studies 32,33 P > .05, as for others, P < .05). 4 of 4 studies demonstrated significant improvements in active abduction, ranging from 19 to 89.21 (P < .05 for three studies, 18,36,41 P > .05 for one).…”

“…All 11 studies [31][32][33][34][35][36][37][38][39][40] (13 items) recorded statistically significant improvements in VAS scores with the mean improvement score ranging from 2.07 to 7.1, P < .001 for all. The mean improvements of ASES scores reporting in 13 [31][32][33][34][35][36][37][38][39][40][41][42][43] (15 items) of 15 studies ranged from 18.1 to 58 (P < .05 for all; Table 3). There were clinically significant improvements in both VAS scores and ASES scores by meeting the MCID threshold (Fig 2).…”

The best options in superior capsular reconstruction

“…Most of the previously reported studies described SCR using fascia lata graft or dermal allograft (Table 1) [20][21][22][23][24][25][26][27][28][29], Various biomechanical studies and clinical results report their use in SCR. Recently, however, various other autografts, allografts, xenografts, and synthetic grafts have been used in SCR, and the clinical results have been reported (Table 2) [30][31][32][33][34].…”

“…Teflon felt has been used for conventional patch graft surgery [51][52][53] (tendon reconstruction for rotator cuff tears), as well as in thoracic and cardiovascular surgery [54]. Okamura et al [34] investigated the clinical and radiographic outcomes and postoperative complications of SCR using a Teflon graft of either 1 or 3 layers. They reported that SCR using a Teflon graft of either 1 or 3 layers significantly improved the ASES and VAS scores and muscle strength in shoulder abduction, with low rates of graft tears and complications after surgery.…”