Alan M. Hirahara, MD, FRCSC
Orthopaedic SurgeonSpecialist in Sports Medicine

Superior Capsular Reconstruction: Outcomes After Minimum 2-year Follow-Up

Hirahara AM, Andersen WJ, Panero AJ
American Journal of Orthopedics
PMID: 29309442

November 1st 2017

The Superior Capsular Reconstruction (SCR) has been described as a method to alleviate pain and disability for irreparable supraspinatus rotator cuff tears. Nine patients had an arthroscopic SCR with a dermal allograft for irreparable rotator cuff tears. These patients were evaluated prospectively with a minimum of 2-year follow-up (mean 32.38 months) by ASES, VAS, acromial-humeral distance (AHD), and ultrasound. Patients were compared pre- and postoperatively and against historical controls who underwent massive rotator cuff repairs. Mean preoperative ASES and VAS scores were 43.54 and 6.25, respectively. These values significantly improved to 86.46 (p < 0.00002) and 0.38 (p < 0.00002), respectively at 2-year follow-up. At end follow-up for the historical controls, the mean ASES scores were 70.71 (p = 0.11) and the mean VAS scores were 3.00 (p < 0.05). The mean AHD improved preoperatively to immediate postoperative follow-up and to 2-year follow-up (4.50 to 8.48 (p < 0.0008) and 7.70 (p < 0.05)). Ultrasound evaluation revealed the appearance of pulsatile vessels within the allograft tissue between four and eight months. One patient required reverse shoulder arthroplasty for anterior escape, and another ruptured the graft after a motor vehicle accident. Our data shows the SCR with a dermal allograft is an effective means to restore the superior restraints in the glenohumeral joint resulting in outstanding clinical outcomes even after two years, making it an excellent, viable alternative to reverse shoulder arthroplasty.