scholarly journals Superior Capsule Reconstruction: Review of a Novel Operative Technique for Management of Irreparable Rotator Cuff Tears

2018 ◽  
Author(s):  
Alexander Golant ◽  
Daiji Kano ◽  
Tony Quach ◽  
Kevin Jiang ◽  
Jeffrey E. Rosen
Keyword(s):  
Rotator Cuff ◽  
Operative Technique ◽  
Rotator Cuff Tears ◽  
Superior Capsule Reconstruction

Superior Capsule Reconstruction to Restore Superior Stability in Irreparable Rotator Cuff Tears

2012 ◽  
Vol 40 (10) ◽  
pp. 2248-2255 ◽  
Author(s):  
Teruhisa Mihata ◽  
Michelle H. McGarry ◽  
Joseph M. Pirolo ◽  
Mitsuo Kinoshita ◽  
Thay Q. Lee
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Superior Capsule Reconstruction

scholarly journals Five-year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

2019 ◽  
Vol 7 (3_suppl2) ◽  
pp. 2325967119S0019 ◽  
Author(s):  
Teruhisa Mihata ◽  
Thay Q. Lee ◽  
Akihiko Hasegawa ◽  
Kunimoto Fukunishi ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Rates Of Return ◽  
Shoulder Range Of Motion ◽  
Superior Capsule Reconstruction ◽  
Significant Difference ◽  
Graft Thickness ◽  
Glenohumeral Osteoarthritis

Objectives: For irreparable rotator cuff tears, we developed a new surgical treatment—arthroscopic superior capsule reconstruction (SCR)—to restore superior shoulder stability, muscle balance, and shoulder function. The objective of this study was to assess (1) changes in functional outcome; (2) changes in graft thickness; (3) rates of graft tear; and (4) rates of glenohumeral osteoarthritis during a 5-year follow-up period. Methods: From 2007 to 2013, arthroscopic SCR using autograft of fascia lata was performed on 37 shoulders with irreparable rotator cuff tears. Seven patients were lost to follow-up. Consequently, 30 shoulders (mean age, 68.0 years) were enrolled in the study. Shoulder range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) scores, acromiohumeral distance (AHD), Hamada grade, and Goutallier grade were compared among before surgery, 1 year after SCR, and 5 years after SCR. Graft thickness, which was measured in MRI, was compared among 3 months, 1 year, and 5 years after SCR. One-way analysis of variance followed by Fisher’s LSD post-hoc test was performed for statistical analysis. In addition, rates of return to sport or work were investigated in those patients who had been employed (12 patients: 5 carpenters, 5 farmers, and 2 construction workers) or played sports (8 patients: 2 table tennis, 1 golf, 1 martial arts, 1 yoga, 1 badminton, 1 mountain-climbing, and 1 ground golf) before injury. Results: Both ASES and JOA scores after arthroscopic SCR improved significantly at both 1 year ( P < 0.001) and 5 years after SCR ( P < 0.001). ASES score at 5 years after SCR was significantly better than that at 1 year after SCR ( P = 0.02). Postoperative ASES scores at both 1 year and 5 years after SCR were better in healed patients (27 patients) than in unhealed patients suffering from graft tear (3 patients). Active elevation was significantly improved at both 1 year and 5 years after SCR ( P < 0.001). At five years after SCR, 11 patients were still working and one patient, who had returned to part-time work at 1 year, had retired. All 8 patients were still playing sport before their injuries at 5 years after SCR. AHD was increased significantly at both 1 and 5 years after SCR ( P < 0.001). There was no significant difference in AHD between 1 and 5 years after SCR ( P = 0.16). In the 27 patients in whom the graft remained intact, graft thickness did not differ significantly among 3 months, 1 year, and 5 years after SCR ( P = 0.67). Hamada grade was significantly improved at both 1 and 5 years after SCR (preoperative: 2.3 ± 0.8; 1 year: 1.3 ± 0.7; 5 years: 1.3 ± 0.7, P < 0.001). All patients who had graft healing had no progression of glenohumeral osteoarthritis during the 5-year follow-up period. Two of the 3 patients with graft tear were suffering severe glenohumeral osteoarthritis (with narrowing of the glenohumeral joint space) at 5 years after SCR. The Goutallier grade did not change significantly after SCR in any patients. Conclusion: In a 5-year follow-up study, arthroscopic SCR restored shoulder function and resulted in high rates of return to recreational sport and work. Shoulder function and ROM were likely to get better with time. Graft tear exacerbated the clinical outcome after SCR and caused glenohumeral osteoarthritis in 2 of 3 patients by 5 years after SCR. Graft thickness and postoperative AHD did not change significantly between 1 and 5 years of follow-up, suggesting that we can expect excellent functional outcomes with long-term follow-up. [Table: see text]

Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

2018 ◽  
Vol 33 (3) ◽  
pp. e9-e12
Author(s):  
Michael A. Stone ◽  
Surena Namdari ◽  
Reza Omid
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Superior Capsule Reconstruction

scholarly journals Outcomes of superior capsule reconstruction for massive rotator cuff tears and risk factors for postoperative retear

2019 ◽  
Vol 140 (10) ◽  
pp. 1319-1325
Author(s):  
Satoru Ohta ◽  
Osamu Komai ◽  
Yuuki Onochi
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Multiple Regression ◽  
Postoperative Outcomes ◽  
Rotator Cuff Tears ◽  
X Rays ◽  
Massive Rotator Cuff Tears ◽  
Superior Capsule Reconstruction ◽  
Stage 4 ◽  
Before And After

Abstract Introduction Superior capsule reconstruction (SCR) has been used for the tendon grafting of massive rotator cuff tears when primary repair is difficult. We examined the postoperative outcomes of SCR for massive rotator cuff tears and the risk factors for postoperative retear. Materials and methods Through this retrospective comparative study, we evaluated 35 patients with an average age of 75.3 (57–90) years who underwent SCR using the technique developed by Mihata et al. Clinical outcomes were evaluated 1 year postoperatively using the Japan Orthopedic Association (JOA) score, University of California Los Angeles (UCLA) shoulder score, elevation angle and the Sugaya classification, which uses a 5-point scale evaluation on magnetic resonance imaging in which types 4 and 5 are considered retears. We also investigated the progression of fatty degeneration before and after surgery and the rupture site of the graft. Acromio-humeral distance (AHD), before and after surgery was measured through X-rays. Rotator cuff tear-related shoulder arthritis was evaluated on plain X-rays using the Hamada stage. Risks of retear were identified using multiple regression analyses for sex, age, Hamada stage and JOA score. Results The JOA score improved from 62.3 ± 9.49 (SD) preoperatively to 84.6 ± 5.66 (SD) postoperatively (P < 0.001). The UCLA score improved from 15.3 ± 3.77 (SD) preoperatively to 30.1 ± 3.11 (SD) postoperatively (P < 0.001). AHD increased from 4.03 mm preoperatively to 6.23 mm postoperatively (P < 0.001). Postoperative retear was observed in seven of the 35 patients. Moreover, retear was observed in five of nine patients with a Hamada stage ≥ 4. Multiple regression analysis revealed that age ≥ 80 years, male sex and Hamada stage ≥ 4 were risk factors for retear. Conclusions While the postoperative outcomes of SCR are favorable, age, sex and degree of arthropathic change should be considered for surgical indications of SCR.

scholarly journals Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

2016 ◽  
Vol 4 (3_suppl3) ◽  
pp. 2325967116S0007 ◽  
Author(s):  
Teruhisa Mihata ◽  
Thay Q. Lee ◽  
Yasuo Itami ◽  
Akihiko HASEGAWA ◽  
Mutsumi Ohue ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Superior Capsule Reconstruction
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