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Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

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Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Francesco DeFilippo, MD, ITALY Alessandro Colosio, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY

University of Brescia, Brescia, ITALY

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Shoulder Rotator Cuff

Treatment / Technique

Autograft

Summary: The use of the long head of the biceps tendon as autograft for superior capsule reconstruction has been proposed in several papers with different techniques, The aim of the present study was to evaluate the clinical outcome of arthroscopic superior capsular reconstruction with long head of the biceps tendon for the treatment of massive irreparable rotator cuff tears

Background

The use of the long head of the biceps tendon as autograft for superior capsule reconstruction has been proposed in several papers with different techniques. Recent biomechanical studies showed that it is biomechanically equivalent and potentially even stronger than fascia lata autograft in the prevention of superior humeral migration. The aim of the present study was to evaluate the clinical outcome of arthroscopic superior capsular reconstruction with long head of the biceps tendon for the treatment of massive irreparable rotator cuff tears. The hypothesis of the study was that superior capsular reconstruction with long head of the biceps tendon could improve subjective and functional outcomes.

Methods

A retrospective study was conducted. Patients with massive irreparable rotator cuff tears of the posterosuperior rotator cuff who underwent arthroscopic superior capsular reconstruction with autologous long head of the biceps tendon were included. Exclusion criteria were: shoulder stiffness, cuff-tear arthropathy, glenohumeral osteoarthritis, symptomatic acromioclavicular joint osteoarthritis, previous fractures and/or previous surgery to the same shoulder. Indication to superior capsular reconstruction was always confirmed arthroscopically after assessing cuff irreparability and testing the long head of the biceps tendon status. All patients underwent the same surgical technique and rehabilitation protocol. The long head of the biceps tendon was freed from its groove using an electrocautery device and then mobilized posteriorly. Two #2 high-strength non-absorbable braided sutures were passed about 5mm apart through the distal aspect of the intraarticular part of the tendon. The tendon was then released one centimeter distal to the most lateral suture and re-routed over the footprint of the posterior aspect of the supraspinatus tendon. The proximal stump of the long head of the biceps tendon was then fixed to the greater tuberosity using one knotless suture anchor. Partial repair of the infraspinatus with suture anchors was performed according to tear configuration and to tendon mobility and reducibility. Side-to-side repair between long head of the biceps and the infraspinatus tendon was also attempted. Primary outcome was the ASES score. Secondary outcomes were: QuickDASH and WORC score. A paired t-test was used to compare pre and postoperative outcomes. Significance was set at p < 0.05.

Results

The study included 12 males and 7 females. Mean age (+ SD) of patients was 61.74 ± 6.13 years. Mean follow-up was 26.61 ± 5.67. Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001).

Conclusion

Arthroscopic superior capsular reconstruction with long head of the biceps tendon for the treatment of massive irreparable rotator cuff tears provides satisfactory subjective and functional outcomes.

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Acromiohumeral Center Edge Angle For Predicting Degenerative Rotator Cuff Tear In Aging Patients: A Retrospective Study ePoster Presentation Sittan Aimprasittichai, MD, THAILAND Nithi Pakmanee, MD, THAILAND Siravich Suvithayasiri, MD, THAILAND Tanadul Jarrusrojwuttikul, MD, THAILAND Sasikarn Wanitchakorn, MD, THAILAND
The Effect On Healing Rate of the Addition Of A Bioinductive Implant To A Rotator Cuff Repair. The Results Of A Randomized Controlled Trial in 124 Subjects. ePoster Presentation Miguel Angel Ruiz Iban, MD, PhD, SPAIN Jose Luis Avila Lafuente, MD, SPAIN Miguel Garcia Navlet, MD, SPAIN Raquel Ruiz Díaz, MD, SPAIN Santos Moros, MD, SPAIN Calos Vaquero Comino, MD, SPAIN Gabriel Del Monte Bello, MD, SPAIN Maria Luisa Rosas, MD, SPAIN Ignacio Rus De Rus Aznar, MD, PhD, SPAIN Paul Sierra, MD, SPAIN Jorge Diaz Diaz Heredia, MD, PhD, SPAIN
Evaluated The Effective Of Tendon Healing After Rotator Cuff Repair Used Modified Mason-Allen Suture Technique Combined With Microfracture Procedure ePoster Presentation Quyet Tran, MD, VIETNAM Viet Duc Vu, MD, VIETNAM Trần Trung Dũng, Professor, MD, PhD, VIETNAM
Does Rotator Cuff Tear Morphology Affect Clinical Outcomes Post-Surgical Repair In Large To Massive Tears? ePoster Presentation Mark H.X. Yeo, MBBS, SINGAPORE Shawn Js Seah, MBBS, SINGAPORE Merrill Lee, MBBS, MRCS(Edin), SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair ePoster Presentation Francesco De Filippo, MD, ITALY Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Giuseppe Bertoni, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY
Usability of the Dynamic Assessment of the Supraspinatus Using Ultrasonography ePoster Presentation Junsuke Miyasaka, MS, JAPAN Ryuzo Arai, MD, JAPAN Yuji Yoshioka, MS, JAPAN Takuma Yuri, PhD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN

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Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

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Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

Background

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content