Augmentation of Massive Rotator Cuff Repairs Using Biceps Transposition Without Tenotomy Improves Clinical and Patient-Reported Outcomes: The Biological Superior Capsular Reconstruction Technique

McClatchy, S. Gray; Parsell, Douglas E.; Hobgood, E. Rhett; Field, Larry D.

doi:10.1016/j.arthro.2023.06.014

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…Recent biomechanical studies utilizing cadaver models have confirmed that SCR with LHBT graft provides sufficient failure strength compared to SCR using a tensor fascia lata autograft [10,20,34,35]. Consequently, various surgical techniques using LHBT grafts for SCR have been introduced and are gaining considerable attention [14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the long head of the biceps tendon (LHBT) has emerged as an alternative to standard SCR grafts. SCR using LHBT has been described in various ways, such as biceps rerouting, biceps transposition, superior capsular augmentation, and anterior cable reconstruction [14][15][16][17][18][19]. This method involves preserving the LHBT's natural attachment on the glenoid side and moving the proximal part backward, making it biomechanically comparable to SCR using a tensor fascia lata (TFL) autograft [10,20].…”

Section: Introductionmentioning

confidence: 99%

“…This method involves preserving the LHBT's natural attachment on the glenoid side and moving the proximal part backward, making it biomechanically comparable to SCR using a tensor fascia lata (TFL) autograft [10,20]. Notably, this technique not only offers a local autologous source of collagen graft but also enables entirely arthroscopic procedures, minimizing donor site morbidity [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon in Large to Massive Rotator Cuff Tears: A Meta-Analysis and Systematic Review

Shin,

Jang,

Han

2024

JCM

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(1) Background: Addressing large to massive rotator cuff tears (LMRCTs) poses complex challenges. This systematic review investigated outcomes of superior capsular reconstruction (SCR) with the long head of the biceps tendon (LHBT) compared to conventional rotator cuff repair (RCR) for LMRCTs. (2) Methods: A systematic search across the MEDLINE/PubMed, EMBASE, Cochrane Library, and Scopus databases until 1 October 2023 identified studies that directly compared SCR with LHBT with conventional RCR in patients with LMRCTs and included a minimum of a 12-month follow-up period. The assessed outcome measures encompassed retear rates, functional outcomes, range of motion (ROM), and acromiohumeral interval (AHI). Risk of bias assessment was conducted via the Robins-I tool. (3) Results: In six studies with 456 cases (210 SCR using LHBT and 246 using RCR), SCR with LHBT significantly reduced retear rates (OR = 0.21; 95% CI, 0.12–0.36; p < 0.01; I2 = 0%). Furthermore, SCR with LHBT showed significant improvement in range of forward flexion (SMD 0.32, 95% CI: 0.09–0.55, p < 0.01, I2 = 39%) and AHI (SMD 0.61, 95% CI: 0.31–0.92, p < 0.01, I2 = 0%) postoperatively. (4) Conclusion: SCR with LHBT is a safe and effective treatment for LMRCTs, reducing retear rates, maintaining greater postoperative AHI, and improving ROM compared to conventional RCR. Additional high-quality interventional studies are needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon in Large to Massive Rotator Cuff Tears: A Meta-Analysis and Systematic Review

Shin,

Jang,

Han

2024

JCM

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“… 2 , 10 , 15 , 40 , 52 , 61 The long head of the biceps tendon (LHBT) has previously been used to create an autograft for SCR augmentation. 2 , 10 , 36 , 38 The LHBT is located inside the shoulder joint and has been successfully used to augment support during rotator cuff repair against biomechanical forces. 48 However, LHBT autograft augmentation may not sufficiently restore a stable fulcrum required for normal kinematics.…”

mentioning

confidence: 99%

Arthroscopic superior capsule reconstruction augmentation using a semitendinosus autograft in massive reparable rotator cuff tears

Funakoshi,

Takahashi,

Murayama

et al. 2024

JSES International

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Reduced retear rates yet similar clinical outcomes following arthroscopic partial repair of large and massive irreparable rotator cuff tears with biceps augmentation compared to repairs without biceps augmentation: A systematic review and meta‐analysis

Thamrongskulsiri,

Limskul,

Tanpowpong

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo compare the clinical outcomes between arthroscopic partial rotator cuff repair with biceps augmentation (BA) and partial repair (PR) without BA.MethodsThis systematic review included studies comparing outcomes of arthroscopic repair for large to massive irreparable rotator cuff tears with and without the BA. The focus was on postoperative clinical results and retear rates. Mean differences were used to express continuous outcomes, while odds ratios (ORs) were employed for dichotomous outcomes.ResultsTen studies (733 shoulders, all level 3 evidence) were included. The BA group showed a significant reduction in retear rates (OR = 0.40, 95% confidence interval [CI]: 0.20–0.77, P = 0.007) and comparable postoperative outcomes across various measures: American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale for pain, University of California‐Los Angeles shoulder score, active forward flexion motion and active external rotation at the arm‐at‐side position compared to the PR group. Subgroup analysis of two BA techniques—rerouting and supplementation following supraglenoid tenotomy—showed no significant differences in ASES score for either technique versus PR. However, rerouting significantly lowered retear rates (OR = 0.21, 95% CI: 0.12–0.36, p < 0.001), while supplementation showed similar retear rates to PR (OR = 0.87, 95% CI: 0.37–2.02, n.s.).ConclusionArthroscopic partial rotator cuff repair with BA for large to massive irreparable rotator cuff tears is a reliable technique, resulting in improved postoperative outcomes. BA using supplementation following supraglenoid tenotomy showed similar clinical outcomes and range of motion but with lower retear rates compared to the PR group.Level of EvidenceLevel III.

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Augmentation of Massive Rotator Cuff Repairs Using Biceps Transposition Without Tenotomy Improves Clinical and Patient-Reported Outcomes: The Biological Superior Capsular Reconstruction Technique

Cited by 7 publications

References 41 publications

Outcomes of Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon in Large to Massive Rotator Cuff Tears: A Meta-Analysis and Systematic Review

Outcomes of Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon in Large to Massive Rotator Cuff Tears: A Meta-Analysis and Systematic Review

Arthroscopic superior capsule reconstruction augmentation using a semitendinosus autograft in massive reparable rotator cuff tears

Reduced retear rates yet similar clinical outcomes following arthroscopic partial repair of large and massive irreparable rotator cuff tears with biceps augmentation compared to repairs without biceps augmentation: A systematic review and meta‐analysis

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