Document Detail


Clinical Results of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.
MedLine Citation:
PMID:  23369443     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The objective of this study was to investigate the clinical outcome and radiographic findings after arthroscopic superior capsule reconstruction (ASCR) for symptomatic irreparable rotator cuff tears. METHODS: From 2007 to 2009, 24 shoulders in 23 consecutive patients (mean, 65.1 years) with irreparable rotator cuff tears (11 large, 13 massive) underwent ASCR using fascia lata. We used suture anchors to attach the graft medially to the glenoid superior tubercle and laterally to the greater tuberosity. We added side-to-side sutures between the graft and infraspinatus tendon and between the graft and residual anterior supraspinatus/subscapularis tendon to improve force coupling. Physical examination, radiography, and magnetic resonance imaging (MRI) were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. Average follow-up was 34.1 months (24 to 51 months) after surgery. RESULTS: Mean active elevation increased significantly from 84° to 148° (P < .001) and external rotation increased from 26° to 40° (P < .01). Acromiohumeral distance (AHD) increased from 4.6 ± 2.2 mm preoperatively to 8.7 ± 2.6 mm postoperatively (P < .0001). There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Twenty patients (83.3%) had no graft tear or tendon retear during follow-up (24 to 51 months). The American Shoulder and Elbow Surgeons (ASES) score improved from 23.5 to 92.9 points (P < .0001). CONCLUSIONS: ASCR restored superior glenohumeral stability and function of the shoulder joint with irreparable rotator cuff tears. Our results suggest that this reconstruction technique is a reliable and useful alternative treatment for irreparable rotator cuff tears. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors:
Teruhisa Mihata; Thay Q Lee; Chisato Watanabe; Kunimoto Fukunishi; Mutsumi Ohue; Tomoyuki Tsujimura; Mitsuo Kinoshita
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  -     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka; Katsuragi Hospital (M.O.), Osaka; and Veritas Hospital (T.T.), Hyogo, Japan; Department of Orthopaedic Biomechanics Laboratory, VA Healthcare System, Long Beach; and University of California, Irvine, CA, U.S.A.. Electronic address: tmihata@yahoo.co.jp.
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