Superior Capsular Reconstruction with Achilles Tendon Allograft

Mease, Samuel J.; Moontasri, Nancy J.; Kurowicki, Jennifer; Long, Charles L.; Simone, Erica S.; Scillia, Anthony J.

doi:10.1016/j.eats.2019.12.007

Cited by 12 publications

(12 citation statements)

References 25 publications

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“…The use of an Achilles tendon--bone allograft for SCR has been previously reported. 27,34 However, these previous reports were technique articles that did not provide clinical or radiographic outcomes. The current study assessed graft integrity serially using MRI scans.…”

Section: Discussionmentioning

confidence: 99%

Failure Rate After Superior Capsular Reconstruction With Achilles Tendon–Bone Allograft for Irreparable Rotator Cuff Tears

Kholinne

Sun

Kwak

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Superior capsular reconstruction (SCR) is an alternative to reverse shoulder arthroplasty for irreparable rotator cuff tears (IRCTs). The reconstructed capsule acts as a static restraint to prevent superior migration of the humeral head. Traditional SCR uses a fascia lata autograft, which has shown failure at the greater tuberosity. An Achilles tendon–bone allograft has been proposed to improve the failure rate. Purpose: To evaluate the surgical outcomes of SCR using an Achilles tendon–bone allograft for the treatment of IRCTs. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively evaluated 6 patients with massive IRCTs who underwent SCR using an Achilles tendon–bone allograft between January 2017 and January 2018. Clinical outcomes were assessed using range of motion, the American Shoulder and Elbow Surgeons score, and the visual analog scale for pain. The acromiohumeral distance and the status of graft integrity were evaluated using serial magnetic resonance imaging. Second-look arthroscopy surgery was performed to evaluate graft integrity at the mean of 7.5 months postoperative. Results: The mean ± SD clinical follow-up period was 14.5 months (range, 12-17 months). The American Shoulder and Elbow Surgeons and visual analog scale scores improved from 42.8 ± 11.9 and 4.0 ± 1.2 to 62.1 ± 14.7 and 2.8 ± 1.4, respectively. Forward flexion and external rotation improved from 98° ± 36° and 58° ± 4° to 123° ± 20° and 39° ± 8°, respectively. The acromiohumeral distance improved from 3.9 ± 0.8 mm to 6.4 ± 2.2 mm at final follow-up. However, second-look arthroscopy at a mean of 7.6 months postoperatively confirmed a graft failure rate of 83.3%. Conclusion: SCR using an Achilles tendon–bone allograft for the treatment of IRCTs had a high graft failure rate among patients in this case series.

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Section: Discussionmentioning

confidence: 99%

Failure Rate After Superior Capsular Reconstruction With Achilles Tendon–Bone Allograft for Irreparable Rotator Cuff Tears

Kholinne

Sun

Kwak

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…T he surgical techniques of SCR derived from Mihata in 2007 11 . Following that, a variety of techniques have been reported 14,16,31,32,34,[43][44][45][46][47] . According to the type of grafts, we summarized two main surgical procedures, one was the ASCR with fascia lata autograft or acellular dermal allograft, another was ASCR with the LHBT.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…As a new arthroscopic technique, SCR with autografts such as fascia lata and the long head of biceps tendon (LHBT), acellular dermal allograft, xenograft or synthetic graft showed significant clinical results in pain, range of motion (ROM), strength, graft healing, and the function 12 . A lot of surgical procedures and indications were addressed because of the discrepancy of the grafts 13 , 14 , 15 , 16 , 17 , 18 .…”

Section: Introductionmentioning

confidence: 99%

Advancement in Arthroscopic Superior Capsular Reconstruction for Irreparable Massive Rotator Cuff Tear

Zhou

Tang

2021

Orthopaedic Surgery

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Irreparable massive rotator cuff tear (IMRCT) was one of the causes of shoulder dysfunction, despite technical improvement, the failure rate of IMRCT was still demonstrated to be high. Traditional treatments like non-surgical treatments, partial rotator cuff repair, and tendon transfers could only achieve a slight improvement. A potential cause for high failure rate was the fact that traditional treatments cannot restore the superior stability of glenohumeral joint, and thus restricted the movement of shoulder joint severely. Superior capsular reconstruction (SCR) using a variety of grafts (autograft, allograft, xenograft, or synthetic grafts) provided a promising option for IMRCT. In surgery, graft was fixed medially to superior glenoid and laterally to the footprint of humeral greater tuberosity. SCR could increase the stability of the superior glenohumeral joint, decrease the subacromial pressure and acromiohumeral distance. This review summarized the relevant literature regarding the alternative grafts, surgery indications, operative techniques and clinical outcomes of SCR. we compared the different grafts, key surgical steps, the advantages and disadvantages of different surgical methods to provide clinicians with new surgical insights into the treatments of IMRCT. In conclusion, IMRCT without severe glenohumeral arthritis was the best suitable indication for SCR. The clinical outcomes were positive in the short-term and middle-term following-up. More studies were necessary to determine long-term results of this surgical procedure.

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“… 2 , 3 , 4 Recently, several new graft sources and techniques for SCR have emerged. 5 , 6 , 7 , 8 , 9 …”

mentioning

confidence: 99%

“…[2][3][4] Recently, several new graft sources and techniques for SCR have emerged. [5][6][7][8][9] In young or active patients with massive RCT without glenohumeral arthritis, joint preservation is the preferable treatment principle. 10 If complete anatomical repair is not possible, partial repair combined with SCR leads to improved functional outcome and active range of motion for active elevation and external rotation.…”

mentioning

confidence: 99%

Superior Capsular Reconstruction With Double Bundle of Long Head Biceps Tendon Autograft: The “Box” Technique

Fandridis

Zampeli

2020

Arthroscopy Techniques

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The superior capsular reconstruction (SCR) is an arthroscopic surgical technique recently introduced as an effective solution to restore the defect of superior articular capsule in massive rotator cuff tears that cannot be repaired anatomically. The SCR retains static stability and inhibits the proximal humeral migration, thereby optimizing the force couples about the shoulder. In this surgical technique paper, we present our technique of SCR using a double bundle construct of long head of biceps tendon, called the “box” technique. It is always combined with partial rotator cuff repair.

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Superior Capsular Reconstruction with Achilles Tendon Allograft

Cited by 12 publications

References 25 publications

Failure Rate After Superior Capsular Reconstruction With Achilles Tendon–Bone Allograft for Irreparable Rotator Cuff Tears

Failure Rate After Superior Capsular Reconstruction With Achilles Tendon–Bone Allograft for Irreparable Rotator Cuff Tears

Advancement in Arthroscopic Superior Capsular Reconstruction for Irreparable Massive Rotator Cuff Tear

Superior Capsular Reconstruction With Double Bundle of Long Head Biceps Tendon Autograft: The “Box” Technique

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