Treatment of irreparable rotator cuff tears with superior capsular reconstruction

Yamamoto, Nobuyuki; Itoi, Eiji

doi:10.1186/s40634-021-00342-1

Cited by 8 publications

(6 citation statements)

References 27 publications

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“… 11 24) One of the working mechanisms of SCR is the spacer effect, and the graft acts as a spacer to compress the humeral head against the acromion. 25) Mihata et al 24) reported that the graft of fascia lata with 8 mm thickness could provide greater shoulder stability than that of a graft with 4 mm thickness. The difference in shoulder stability provided by grafts with different thicknesses revealed that the graft functions as a spacer.…”

Section: Discussionmentioning

confidence: 99%

Do Magnets Have the Potential to Serve as a Stabilizer for the Shoulder Joint in Massive Rotator Cuff Tears?: A Biomechanical Cadaveric Study

Jeon

et al. 2023

Clin Orthop Surg

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Background Disruption of the rotator cuff muscles compromises concavity compression force, which leads to superior migration of the humeral head and loss of stability. A novel idea of using the magnetic force to achieve shoulder stabilization in massive rotator cuff tears (MRCTs) was considered because the magnets can stabilize two separate entities with an attraction force. This study aimed to investigate the biomechanical effect of the magnetic force on shoulder stabilization in MRCTs. Methods Seven fresh frozen cadaveric specimens were used with a customized shoulder testing system. Three testing conditions were set up: condition 1, intact rotator cuff without magnets; condition 2, an MRCT without magnets; condition 3, an MRCT with magnets. For each condition, anterior-posterior translation, superior translation, superior migration, and subacromial contact pressure were measured at 0°, 30°, and 60° of abduction. The abduction capability of condition 2 was compared with that of condition 3. Results The anterior-posterior and superior translations increased in condition 2; however, they decreased compared to condition 2 when the magnets were applied (condition 3) in multiple test positions and loadings ( p < 0.05). Abduction capability improved significantly in condition 3 compared with that in condition 2, even for less deltoid loading ( p < 0.05). Conclusions The magnet biomechanically played a positive role in stabilizing the shoulder joint and enabled abduction with less deltoid force in MRCTs. However, to ensure that the magnet is clinically applicable as a stabilizer for the shoulder joint, it is necessary to thoroughly verify its safety in the human body and to conduct further research on technical challenges.

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Section: Discussionmentioning

confidence: 99%

Do Magnets Have the Potential to Serve as a Stabilizer for the Shoulder Joint in Massive Rotator Cuff Tears?: A Biomechanical Cadaveric Study

Jeon

et al. 2023

Clin Orthop Surg

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“…SCR is indicated with young, active patients with massive rotator cuff tears, have a functional cuff deficiency from a failed a previous rotator cuff repair (Hamada Grade 1 or 2), and no significant glenohumeral arthritis. [3][4][5] The indications for the InSpace balloon (Stryker; Kalamazoo, Michigan) are similar to SCR, although the balloon can be used in patients who may not be able to partake in the extensive SCR rehabilitation. Tendon transfer is utilized in young, non-arthritic, heavy laboring patients who require improved strength.…”

Section: Video Transcriptmentioning

confidence: 99%

Section: Video Transcriptmentioning

confidence: 99%

Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears: Technique and Associated Considerations

Kerzner

Swindell

Dasari

et al. 2022

Video Journal of Sports Medicine

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Background: Massive rotator cuff tears lead to superior humeral head translation and may prevent successful repair. Superior capsular reconstruction (SCR) can overcome this by improving the compression and depressor effects of the rotator cuff and joint capsule simultaneously. Indications: SCR is indicated in young, active patients with massive rotator cuff tears or a functional cuff deficiency from a failed previous rotator cuff repair without significant arthritis, articulation of the humeral head with the acromion, or dysfunctional deltoid. Technique Description: During the procedure, repair of the subscapularis is performed using a polydioxanone (PDS) suture shuttling device to pass suture through the subscapularis in an inverted mattress knotless configuration. Posterior infraspinatus tendon fibers are reduced and the tuberosity is abraded and decorticated followed by completion of the partial repair of the posterior cuff. Anchors are placed on the glenoid and articular margins followed by preparation of the dermal allograft with luggage tags medially and perforation laterally. The graft is passed and secured in a double row configuration laterally with apposition of the graft to the remnant, repaired rotator cuff posteriorly. Results: Passive range of motion (ROM) is begun at week 4, followed by progressive active ROM at weeks 6 to 12, and advancement of full ROM and advanced strengthening begun at 3 months. With SCR, a patient can expect maximal strength and function to be regained at 1 year postoperatively. Significant clinical improvement following SCR has been seen in visual analog scale (VAS) and American Shoulder and Elbow Surgeons Shoulder Score (ASES) scores for most patients, although there is a varied degree of return to sport following this procedure. Discussion/Conclusion: Clinical evidence suggests that SCR is a beneficial therapeutic intervention for short to medium term outcomes in younger patients with massive, irreparable rotator cuff tears. More studies are needed to identify the optimal thickness of the graft.

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“… 30 This leads to a significant clinical improvement in biomechanical function and pain at the glenohumeral joint. 17 , 31 …”

mentioning

confidence: 99%

“…Biomechanically, cadaveric studies have largely demonstrated positive results with SCR. 31 The procedure leads to a significant decrease in the superior translation of the humeral head and in subacromial contact pressures. 14 This biomechanical benefit of SCR has translated to the clinical setting with generally positive results.…”

mentioning

confidence: 99%

A biomechanical study to optimize superior capsular reconstruction operative technique

Dasari¹,

Vadhera²,

Menendez³

et al. 2024

JSES International

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Treatment of irreparable rotator cuff tears with superior capsular reconstruction

Cited by 8 publications

References 27 publications

Do Magnets Have the Potential to Serve as a Stabilizer for the Shoulder Joint in Massive Rotator Cuff Tears?: A Biomechanical Cadaveric Study

Do Magnets Have the Potential to Serve as a Stabilizer for the Shoulder Joint in Massive Rotator Cuff Tears?: A Biomechanical Cadaveric Study

Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears: Technique and Associated Considerations

A biomechanical study to optimize superior capsular reconstruction operative technique

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