Clinical and Radiologic Outcomes of Augmented Partial Repair with Acellular Dermal Allograft and Superior Capsular Reconstruction in Massive Rotator Cuff Tears: 2-Year Follow-Up.

Abstract

Background/Objectives: To evaluate the clinical and radiologic outcomes of arthroscopic augmented partial repair (APR) with acellular dermal matrix versus arthroscopic superior capsular reconstruction (SCR) in massive rotator cuff tears. Methods: The study included a total of 49 patients with massive rotator cuff tears who underwent arthroscopic APR (26 patients) and SCR (23 patients) between March 2018 and June 2021. Clinical scores, visual analog scores, and range of motion were collected preoperatively and postoperatively until the last follow-up. Preoperative and postoperative simple radiographs were evaluated for arthropathic changes and acromiohumeral distances (AHDs). Magnetic resonance imaging was performed to assess the integrity of repaired structures at 12 months postoperatively. Results: The average age of patients was 63.9 years (range 53-74 years), and the mean clinical follow-up period was 2.6 years (range 2.1-2.9). The average UCLA scores improved from 18.0 to 33.2 and from 16.3 to 32.1 in APR and SCR groups at the last follow-up, respectively. For the ranges of motion, the APR group consistently showed better external rotation ranges from the postoperative 6th month until the last follow-up (p < 0.05), and the APR group revealed better ranges of motion in forward flexion, abduction, and external rotation compared to the SCR group (p < 0.05). Postoperative AHD showed better improvement in the APR group than the SCR group (p < 0.05). Re-tears were found in two patients in each group (p > 0.05). Conclusions: Both APR and SCR groups showed comparable improvement in clinical outcomes in massive rotator cuff tears, while the APR group showed statistically significant improvement in the range of motion compared to the SCR group, especially for external rotations.