Arthroscopic superior capsular reconstruction versus reverse shoulder arthroplasty in patients with massive irreparable rotator cuff tears: A comparative clinical study.

IF 1.1 4区医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2023-07-01 DOI:10.5152/j.aott.2023.23049

Alper Şükrü Kendirci, Mehmet Chodza, Koray Şahin, Serkan Bayram, Taha Kızılkurt, Ali Erşen

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Abstract

Objective: This study aimed to compare the clinical and functional outcomes of reverse shoulder arthroplasty versus arthroscopic supe- rior capsular reconstruction in the treatment of patients with massive irreparable rotator cuff tears and Hamada grade 1-2 glenohumeral arthritis.

Methods: It is a retrospective case-control study comparing the prospective results of 2 different treatment methods. This retrospective comparison of groups was conducted between May 2016 and May 2020. The study included 40 people with massive irreparable rotator cuff tear and Hamada grade 1-2 arthropathy who had arthroscopic superior capsular reconstruction with tensor fascia latae autograft or reverse shoulder arthroplasty surgery. Patients were divided into 2 groups according to treatment. Clinical outcome measures included shoulder range of motion, pain, and functional scores (Constant-Murley, American Shoulder and Elbow Surgeons).

Results: The mean age was 61.85 ± 7.56 and 71.10 ± 6.42 years, respectively, for group I [superior capsular reconstruction (n=20)] and group II [superior capsular reconstruction (n=20)]. The mean follow-up was 22.30 ± 8.4 and 32.50 ± 8.11 months, respectively. In the postoperative data, flexion degrees and Constant scores were significantly higher in the superior capsular reconstruction group (P=.007, P = .043). No significant difference was found between the 2 groups in all parameters (P > .05) except abduction. The increase in abduction value in the reverse shoulder arthroplasty group was significantly higher than in the superior capsular reconstruction group (P = .003). In addition, postoperative data in all parameters in both groups showed significant changes compared to preoperatively.

Conclusion: This study has shown that superior capsular reconstruction with tensor fascia latae autograft can provide clinical and func- tional improvement similar to the reverse shoulder arthroplasty procedure in treating massive irreparable rotator cuff tears with Hamada grade 1-2 arthropathy.

Level of evidence: Level III, Therapeutic Study.

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关节镜下肩袖大面积不可修复撕裂患者上囊重建与反肩关节置换术的比较临床研究。

目的：本研究旨在比较反向肩关节置换术与关节镜下关节囊重建术治疗肩袖大面积不可修复撕裂和Hamada 1-2级肩关节炎的临床和功能结果。方法：这是一项回顾性病例对照研究，比较了两种不同治疗方法的前瞻性结果。该组的回顾性比较是在2016年5月至2020年5月期间进行的。这项研究包括40名患有严重不可修复的肩袖撕裂和Hamada 1-2级关节病的患者，他们接受了关节镜下自体阔筋膜张肌移植或反向肩关节置换术重建上囊。根据治疗将患者分为2组。临床结果测量包括肩部活动范围、疼痛和功能评分（Constant Murley，American shoulder and Elbow Surgeons）。结果：I组[上囊重建术（n=20）]和II组[上膜重建术（n=20）]的平均年龄分别为61.85±7.56和71.10±6.42岁。平均随访时间分别为22.30±8.4和32.50±8.11个月。在术后数据中，上囊重建组的屈曲度和Constant评分显著较高（P=0.007，P=0.043）。除外展外，两组在所有参数上均无显著差异（P>0.05）。反肩关节置换术组外展值的增加明显高于上囊重建组（P=0.003）。此外，两组的术后所有参数数据均显示出与术前相比的显著变化。结论：本研究表明，自体阔筋膜张肌移植物重建上囊可以提供类似于反向肩关节置换术的临床和功能改善，以治疗Hamada 1-2级关节病的巨大不可修复的肩袖撕裂。证据级别：三级，治疗性研究。

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来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.