The short-term effectiveness of superior capsular reconstruction using autologous fascia lata graft for irreparable massive rotator cuff tears_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Huaisheng , MA Lin ^△ , LI Yan , TAO Xu , LIAO Yatao , YANG Aining ,  ZHOU Binghua ,  TANG Kanglai

Department of Orthopedics/Sports Medicine Center, the First Affiliated Hospital of the Army Military Medical University, Chongqing, 400038, P.R.China;

Corresponding author：

ZHOU Binghua, Email: yijian510868@hotmail.com; TANG Kanglai, Email: tangkanglai@hotmail.com

Keywords：

Irreparable massive rotator cuff tear; autografting; fascia lata; superior capsular; reconstruction

DOI：

10.7507/1002-1892.202104003

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To observe and evaluate the short-term effectiveness of superior capsular reconstruction using autologous fascia lata graft for irreparable massive rotator cuff tears. Methods The clinical data of 9 patients with irreparable massive rotator cuff tears treated with arthroscopic superior capsular reconstruction by using autologous fascia lata graft between September 2019 and April 2020 were retrospectively analysed. There were 4 males and 5 females with a median age of 66 years (range, 55-70 years). The disease duration was 6-60 months with an average of 19.1 months. According to Hamada classification, the patients were classified as grade 1 in 2 cases, grade 2 in 2 cases, grade 3 in 2 cases, and grade 4 in 3 cases. Before and after operation, the visual analogue scale (VAS) score was used to evaluate the improvement of shoulder joint pain, the American Shoulder and Elbow Surgeons (ASES) score, Constant score, and the University of California Los Angeles (UCLA) shoulder function score were used to evaluate the improvement of shoulder joint function. The active range of motion of shoulder joint was recorded, including forward flexion, abduction, lateral external rotation, and internal rotation. The changes of subacromial space were recorded by anteroposterior X-ray film of shoulder joint. Sugaya classification was used to judge the integrity of rotator cuff immediately after operation and at last follow-up. Results The operation time was 210-380 minutes, with an average of 302.3 minutes. All incisions healed by first intention after operation, and there was no complication such as infection and nonunion of incisions. Two patients had numbness of the upper limbs on the surgical side after operation, and the numbness completely relieved at 6 weeks after operation; 5 cases with preoperative pseudoparalysis symptoms recovered after operation. Nine patients were followed up 12-17 months, with an average of 14.1 months. At last follow-up, the patient’s active range of motion of shoulder joint (forward flexion, abduction, lateral external rotation, and internal rotation), subacromial space distance, VAS score, ASES score, Constant score, and UCLA score significantly improved when compared with preoperative ones (P<0.05). There was no significant difference in the Sugaya classification between at last follow-up and immediately after operation (Z=−1.633, P=0.102). Conclusion Superior capsular reconstruction using autologous fascia lata graft can restore the superior stability and achieve a good short-term effectiveness for irreparable massive rotator cuff tears.

Citation： LI Huaisheng, MA Lin, LI Yan, TAO Xu, LIAO Yatao, YANG Aining, ZHOU Binghua, TANG Kanglai. The short-term effectiveness of superior capsular reconstruction using autologous fascia lata graft for irreparable massive rotator cuff tears. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(11): 1427-1433. doi: 10.7507/1002-1892.202104003 Copy

1.	Habermeyer P, Krieter C, Tang KL, et al. A new arthroscopic classification of articular-sided supraspinatus footprint lesions: a prospective comparison with Snyder’s and Ellman’s classification. J Shoulder Elbow Surg, 2008, 17(6): 909-913.
2.	李怀胜, 杨明宇, 李焱, 等. 肩关节上关节囊重建治疗肩袖损伤适应证和移植物处理方法研究进展. 中国修复重建外科杂志, 2021, 35(2): 252-257.
3.	Franceschi F, Papalia R, Vasta S, et al. Surgical management of irreparable rotator cuff tears. Knee Surg Sports Traumatol Arthrosc, 2015, 23(2): 494-501.
4.	Castricini R, De Benedetto M, Orlando N, et al. Irreparable rotator cuff tears: a novel classification system. Musculoskelet Surg, 2014, 98 Suppl 1: 49-53.
5.	Cvetanovich GL, Waterman BR, Verma NN, et al. Management of the irreparable rotator cuff tear. J Am Acad Orthop Surg, 2019, 27(24): 909-917.
6.	Juhan T, Stone M, Jalali O, et al. Irreparable rotator cuff tears: Current treatment options. Orthop Rev (Pavia), 2019, 11(3): 8146. doi: 10.4081/or.2019.8146.
7.	Wall KC, Toth AP, Garrigues GE. How to use a graft in irreparable rotator cuff tears: A literature review update of interposition and superior capsule reconstruction techniques. Curr Rev Musculoskelet Med, 2018, 11(1): 122-130.
8.	Castricini R, Galasso O, Riccelli DA, et al. Arthroscopic partial repair of irreparable, massive rotator cuff tears. Arthrosc Tech, 2017, 6(1): e143-e147.
9.	Al-Hadithy N, Domos P, Sewell MD, et al. Reverse shoulder arthroplasty in 41 patients with cuff tear arthropathy with a mean follow-up period of 5 years. J Shoulder Elbow Surg, 2014, 23(11): 1662-1668.
10.	Muench LN, Kia C, Williams AA, et al. High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears. Arthroscopy, 2020, 36(1): 88-94.
11.	Matsuki K, Hoshika S, Ueda Y, et al. Three-dimensional kinematics of reverse shoulder arthroplasty: a comparison between shoulders with good or poor elevation. JSES Int, 2021, 5(3): 353-359.
12.	Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy, 2013, 29(3): 459-470.
13.	Hirahara AM, Adams CR. Arthroscopic superior capsular reconstruction for treatment of massive irreparable rotator cuff tears. Arthrosc Tech, 2015, 4(6): e637-641.
14.	de Campos Azevedo CI, Ângelo ACLPG, Vinga S. Arthroscopic superior capsular reconstruction with a minimally invasive harvested fascia lata autograft produces good clinical results. Orthop J Sports Med, 2018, 6(11): 2325967118808242. doi: 10.1177/2325967118808242.
15.	Petri M, Greenspoon JA, Millett PJ. Arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthrosc Tech, 2015, 4(6): e751-755.
16.	Sanchez G, Rossy WH, Lavery KP, et al. Arthroscopic superior capsule reconstruction technique in the setting of a massive, irreparable rotator cuff tear. Arthrosc Tech, 2017, 6(4): e1399-e1404.
17.	Burkhart SS, Pranckun JJ, Hartzler RU. Superior capsular reconstruction for the operatively irreparable rotator cuff tear: Clinical outcomes are maintained 2 years after surgery. Arthroscopy, 2020, 36(2): 373-380.
18.	Millstein ES, Snyder SJ. Arthroscopic evaluation and management of rotator cuff tears. Orthop Clin North Am, 2003, 34(4): 507-520.
19.	郑小龙, 李焱, 穆米多, 等. 麻醉下手法松解联合关节镜下关节囊松解和肩峰下滑囊清理治疗原发性冻结肩的中期疗效. 中国修复重建外科杂志, 2020, 34(6): 737-743.
20.	Rosales-Varo AP, Zafra M, García-Espona MA, et al. Superior capsular reconstruction of irreparable rotator cuff tear using autologous hamstring graft. Rev Esp Cir Ortop Traumatol (Engl Ed), 2019, 63(1): 1-6.
21.	Tokish JM, Beicker C. Superior capsule reconstruction technique using an acellular dermal allograft. Arthrosc Tech, 2015, 4(6): e833-839.
22.	Hohn EA, Gillette BP, Burns JP. Outcomes of arthroscopic revision rotator cuff repair with acellular human dermal matrix allograft augmentation. J Shoulder Elbow Surg, 2018, 27(5): 816-823.
23.	Chillemi C, Mantovani M, Gigante A. Superior capsular reconstruction of the shoulder: the ABC (Arthroscopic Biceps Chillemi) technique. Eur J Orthop Surg Traumatol, 2018, 28(6): 1215-1223.
24.	Kocaoglu B, Firatli G, Ulku TK. Partial rotator cuff repair with superior capsular reconstruction using the biceps tendon is as effective as superior capsular reconstruction using a tensor fasciae latae autograft in the treatment of irreparable massive rotator cuff tears. Orthop J Sports Med, 2020, 8(6): 2325967120922526. doi: 10.1177/2325967120922526.
25.	尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建 (Chinese Way) 修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.
26.	Delaney RA, Kadow TR, Garcia D, et al. Latissimus dorsi tendon transfer vs. superior capsular reconstruction for treatment of irreparable rotator cuff tears: A retrospective comparison study with short-term clinical results. JSES Open Access, 2019, 3(4): 249.
27.	Rybalko D, Bobko A, Amirouche F, et al. The biomechanics of the supraspinatus-deficient shoulder treated with superior capsular reconstruction vs. reverse total shoulder arthroplasty-experimental study. Int Orthop, 2020, 44(11): 2371-2377.
28.	Adrian SC, Field LD. Biceps transposition for biological superior capsular reconstruction. Arthrosc Tech, 2020, 9(6): e841-e846.
29.	Proctor CS. Long-term successful arthroscopic repair of large and massive rotator cuff tears with a functional and degradable reinforcement device. J Shoulder Elbow Surg, 2014, 23(10): 1508-1513.
30.	Mihata T, McGarry MH, Pirolo JM, et al. Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: a biomechanical cadaveric study. Am J Sports Med, 2012, 40(10): 2248-2255.
31.	Gillespie RJ, Knapik DM, Akkus O. Biologic and synthetic grafts in the reconstruction of large to massive rotator cuff tears. J Am Acad Orthop Surg, 2016, 24(12): 823-828.
32.	李焱, 马林, 杨明宇, 等. 关节镜下垂直褥式缝合关节囊治疗肩关节复发性前脱位合并关节松弛症的早期临床疗效. 中国修复重建外科杂志, 2020, 34(11): 1392-1398.
33.	Osti L, Milani L, Gerace E, et al. Arthroscopic superior capsular reconstruction versus latissimus dorsi transfer for irreparable rotator cuff lesions: a systematic review. Br Med Bull, 2020, 134(1): 85-96.
34.	Smith TJ, Gowd AK, Kunkel J, et al. Clinical outcomes of superior capsular reconstruction for massive, irreparable rotator cuff tears: A systematic review comparing acellular dermal allograft and autograft fascia lata. Arthrosc Sports Med Rehabil, 2020, 3(1): e257-e268.
35.	Campbell AL, Baron SL, Pham H, et al. MRI of superior capsular reconstruction graft and associated short-term clinical outcomes in patients with massive irreparable rotator cuff tears. Clin Imaging, 2021, 70: 74-80.
36.	Gilat R, Haunschild ED, Williams BT, et al. Patient factors associated with clinical failure following arthroscopic superior capsular reconstruction. Arthroscopy, 2021, 37(2): 460-467.

1. Habermeyer P, Krieter C, Tang KL, et al. A new arthroscopic classification of articular-sided supraspinatus footprint lesions: a prospective comparison with Snyder’s and Ellman’s classification. J Shoulder Elbow Surg, 2008, 17(6): 909-913.
2. 李怀胜, 杨明宇, 李焱, 等. 肩关节上关节囊重建治疗肩袖损伤适应证和移植物处理方法研究进展. 中国修复重建外科杂志, 2021, 35(2): 252-257.
3. Franceschi F, Papalia R, Vasta S, et al. Surgical management of irreparable rotator cuff tears. Knee Surg Sports Traumatol Arthrosc, 2015, 23(2): 494-501.
4. Castricini R, De Benedetto M, Orlando N, et al. Irreparable rotator cuff tears: a novel classification system. Musculoskelet Surg, 2014, 98 Suppl 1: 49-53.
5. Cvetanovich GL, Waterman BR, Verma NN, et al. Management of the irreparable rotator cuff tear. J Am Acad Orthop Surg, 2019, 27(24): 909-917.
6. Juhan T, Stone M, Jalali O, et al. Irreparable rotator cuff tears: Current treatment options. Orthop Rev (Pavia), 2019, 11(3): 8146. doi: 10.4081/or.2019.8146.
7. Wall KC, Toth AP, Garrigues GE. How to use a graft in irreparable rotator cuff tears: A literature review update of interposition and superior capsule reconstruction techniques. Curr Rev Musculoskelet Med, 2018, 11(1): 122-130.
8. Castricini R, Galasso O, Riccelli DA, et al. Arthroscopic partial repair of irreparable, massive rotator cuff tears. Arthrosc Tech, 2017, 6(1): e143-e147.
9. Al-Hadithy N, Domos P, Sewell MD, et al. Reverse shoulder arthroplasty in 41 patients with cuff tear arthropathy with a mean follow-up period of 5 years. J Shoulder Elbow Surg, 2014, 23(11): 1662-1668.
10. Muench LN, Kia C, Williams AA, et al. High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears. Arthroscopy, 2020, 36(1): 88-94.
11. Matsuki K, Hoshika S, Ueda Y, et al. Three-dimensional kinematics of reverse shoulder arthroplasty: a comparison between shoulders with good or poor elevation. JSES Int, 2021, 5(3): 353-359.
12. Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy, 2013, 29(3): 459-470.
13. Hirahara AM, Adams CR. Arthroscopic superior capsular reconstruction for treatment of massive irreparable rotator cuff tears. Arthrosc Tech, 2015, 4(6): e637-641.
14. de Campos Azevedo CI, Ângelo ACLPG, Vinga S. Arthroscopic superior capsular reconstruction with a minimally invasive harvested fascia lata autograft produces good clinical results. Orthop J Sports Med, 2018, 6(11): 2325967118808242. doi: 10.1177/2325967118808242.
15. Petri M, Greenspoon JA, Millett PJ. Arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthrosc Tech, 2015, 4(6): e751-755.
16. Sanchez G, Rossy WH, Lavery KP, et al. Arthroscopic superior capsule reconstruction technique in the setting of a massive, irreparable rotator cuff tear. Arthrosc Tech, 2017, 6(4): e1399-e1404.
17. Burkhart SS, Pranckun JJ, Hartzler RU. Superior capsular reconstruction for the operatively irreparable rotator cuff tear: Clinical outcomes are maintained 2 years after surgery. Arthroscopy, 2020, 36(2): 373-380.
18. Millstein ES, Snyder SJ. Arthroscopic evaluation and management of rotator cuff tears. Orthop Clin North Am, 2003, 34(4): 507-520.
19. 郑小龙, 李焱, 穆米多, 等. 麻醉下手法松解联合关节镜下关节囊松解和肩峰下滑囊清理治疗原发性冻结肩的中期疗效. 中国修复重建外科杂志, 2020, 34(6): 737-743.
20. Rosales-Varo AP, Zafra M, García-Espona MA, et al. Superior capsular reconstruction of irreparable rotator cuff tear using autologous hamstring graft. Rev Esp Cir Ortop Traumatol (Engl Ed), 2019, 63(1): 1-6.
21. Tokish JM, Beicker C. Superior capsule reconstruction technique using an acellular dermal allograft. Arthrosc Tech, 2015, 4(6): e833-839.
22. Hohn EA, Gillette BP, Burns JP. Outcomes of arthroscopic revision rotator cuff repair with acellular human dermal matrix allograft augmentation. J Shoulder Elbow Surg, 2018, 27(5): 816-823.
23. Chillemi C, Mantovani M, Gigante A. Superior capsular reconstruction of the shoulder: the ABC (Arthroscopic Biceps Chillemi) technique. Eur J Orthop Surg Traumatol, 2018, 28(6): 1215-1223.
24. Kocaoglu B, Firatli G, Ulku TK. Partial rotator cuff repair with superior capsular reconstruction using the biceps tendon is as effective as superior capsular reconstruction using a tensor fasciae latae autograft in the treatment of irreparable massive rotator cuff tears. Orthop J Sports Med, 2020, 8(6): 2325967120922526. doi: 10.1177/2325967120922526.
25. 尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建 (Chinese Way) 修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.
26. Delaney RA, Kadow TR, Garcia D, et al. Latissimus dorsi tendon transfer vs. superior capsular reconstruction for treatment of irreparable rotator cuff tears: A retrospective comparison study with short-term clinical results. JSES Open Access, 2019, 3(4): 249.
27. Rybalko D, Bobko A, Amirouche F, et al. The biomechanics of the supraspinatus-deficient shoulder treated with superior capsular reconstruction vs. reverse total shoulder arthroplasty-experimental study. Int Orthop, 2020, 44(11): 2371-2377.
28. Adrian SC, Field LD. Biceps transposition for biological superior capsular reconstruction. Arthrosc Tech, 2020, 9(6): e841-e846.
29. Proctor CS. Long-term successful arthroscopic repair of large and massive rotator cuff tears with a functional and degradable reinforcement device. J Shoulder Elbow Surg, 2014, 23(10): 1508-1513.
30. Mihata T, McGarry MH, Pirolo JM, et al. Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: a biomechanical cadaveric study. Am J Sports Med, 2012, 40(10): 2248-2255.
31. Gillespie RJ, Knapik DM, Akkus O. Biologic and synthetic grafts in the reconstruction of large to massive rotator cuff tears. J Am Acad Orthop Surg, 2016, 24(12): 823-828.
32. 李焱, 马林, 杨明宇, 等. 关节镜下垂直褥式缝合关节囊治疗肩关节复发性前脱位合并关节松弛症的早期临床疗效. 中国修复重建外科杂志, 2020, 34(11): 1392-1398.
33. Osti L, Milani L, Gerace E, et al. Arthroscopic superior capsular reconstruction versus latissimus dorsi transfer for irreparable rotator cuff lesions: a systematic review. Br Med Bull, 2020, 134(1): 85-96.
34. Smith TJ, Gowd AK, Kunkel J, et al. Clinical outcomes of superior capsular reconstruction for massive, irreparable rotator cuff tears: A systematic review comparing acellular dermal allograft and autograft fascia lata. Arthrosc Sports Med Rehabil, 2020, 3(1): e257-e268.
35. Campbell AL, Baron SL, Pham H, et al. MRI of superior capsular reconstruction graft and associated short-term clinical outcomes in patients with massive irreparable rotator cuff tears. Clin Imaging, 2021, 70: 74-80.
36. Gilat R, Haunschild ED, Williams BT, et al. Patient factors associated with clinical failure following arthroscopic superior capsular reconstruction. Arthroscopy, 2021, 37(2): 460-467.

Chinese Journal of Reparative and Reconstructive Surgery

The short-term effectiveness of superior capsular reconstruction using autologous fascia lata graft for irreparable massive rotator cuff tears

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content