Superior capsular reconstruction (SCR) – results after reconstruction with a porcine extracellular matrix graft.

Publikation: KonferencebidragAbstractFormidling

Abstract

Introduction
A prerequisite for a satisfying functional result in the treatment of an irreparable rotator cuff rupture is a significant reduction of shoulder pain and better range of motion with an increase in anatomical glenohumeral joint stability.

Purpose
Prospective study to examine the outcome after superior capsular reconstruction using a porcine extracellular matrix dermal graft. A special emphasis was primarily on the functional outcome, secondarily on radiographical shoulder changes, that superior capsular reconstruction might yield.

Methods
Clinical results were evaluated using the Constant score and WORC index over a 2-year period. All patients had magnetic resonance imaging of the injured shoulder after one year. Graft integration and durability were qualitatively estimated as well as any graft deterioration or resorption.
Results
13 patients with 13 superior capsular reconstructions were included over a 3-year period. Mean age was 61 years (range 50 to 70) at the time of surgery. At final follow-up (mean 24 months, range 23 to 32) the mean Constant score had improved from an average of 24,9 points to 55,7 points. The mean WORC index had increased from an percentage average of 32,3 % to 61,9 %. 11 out of 13 grafts were intact on follow-up magnetic resonance imaging (MRI).

Conclusion
Our hypothesis was that successful implantation of a dermal xenograft would correlate with both better functional outcome and stabilized glenohumeral radiographical features. We saw a group of patients with variable but significant increases in functional results and in general with limited pain and with an intact xenograft on an MRI scan. We did not find a positive correlation between functional outcome scores and graft durability nor with single cuff tendon defects versus larger rotator cuff defects.
This study suggests that a superior capsular reconstruction can yield results that are comparable or superior to other known salvage treatment options in patients with large to massive rotator cuff defects without significant cuff tear arthropathy. The hypothesis that superior capsular reconstruction can be a relevant treatment method for irreparable rotator cuff tears could not be refuted despite a fairly low patient inclusion number. With these results, selected patients can be considered for a different treatment than reverse shoulder arthroplasty, debridement or tendon transfer.
OriginalsprogEngelsk
StatusUdgivet - 22 okt. 2020
BegivenhedDansk Ortopædisk Selskabs Årsmøde - København, Danmark
Varighed: 22 okt. 202024 okt. 2020

Konference

KonferenceDansk Ortopædisk Selskabs Årsmøde
Land/OmrådeDanmark
ByKøbenhavn
Periode22/10/2024/10/20

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