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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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Muscle Edema of Retraction and Pseudo Fatty Infiltration After Traumatic Rotator Cuff Tears as an Experimental Model in Sheep ePoster Presentation Tiago Martinho, MD, SWITZERLAND Joe Chih-Hao Chiu, MD, PhD, TAIWAN Marko Nabergoj, MD, SLOVENIA Sean W.L. Ho, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), SINGAPORE Hugo Bothorel, MEng, SWITZERLAND Alexandre Lädermann, MD, SWITZERLAND
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Primary Cuff Repair Augmented With Balloon Spacer in a Majority Massive Rotator Cuff Tear Series - A Short Term Outcome and Imaging Study ePoster Presentation Seng Juong Wong, MBChB, MRCS, SINGAPORE Hannah Marian Lie, Medical Student, SINGAPORE Muhammad Danish Bin Massuryono, Medical Student, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
A Cohort Study on Influence of Rotator Cuff Muscle Strength in Functional Outcomes of Arthroscopic Rotator Cuff Repair ePoster Presentation Rajkumar S. Amaravathi, MBBS, DNB, MNAMS, FRCS, INDIA henry mathews, ms, INDIA Padmanaban Sekaran, MSc PT, INDIA Anoop Pilar, MS, DNB, INDIA
Outcome Comparison Between Arthroscopic Repair of Full-Thickness Rotator Cuff Tear and Partial-Thickness Rotator Cuff Tear ePoster Presentation Andres Eduardo Rodriguez Borgonovo, MD, AUSTRALIA Mark David Haber, MBBS, FRACS, AUSTRALIA Noam Rosen, MD, AUSTRALIA Dvir Shalom Ben Shabat, MD, AUSTRALIA
Impact of Patient Resilience on Rotator Cuff Repair Post-Operative Outcomes ePoster Presentation Ryan W. Paul, BS, UNITED STATES Michael P Campbell, MD, UNITED STATES Sydney Streicher, BA, UNITED STATES Matthew P Wallingford, BS, UNITED STATES Taylor D'Amore, MD, UNITED STATES Sean Bryan, MD, UNITED STATES Fotios P. Tjoumakaris, MD, UNITED STATES Kevin Freedman, MD, UNITED STATES
A Diagnostic Subacromial Injection of Local Anesthetic Significantly Improves the Efficacy of Arthroscopic Shoulder Subacromial Decompression ePoster Presentation John G. Lane, MD, UNITED STATES Tyler Jordan Wipf, PA-C, UNITED STATES Paw Wah, BS, UNITED STATES
Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review ePoster Presentation Olivia Bono, BS, UNITED STATES Bryan Jenkin, BA, UNITED STATES Julaine Forlizzi , MD, UNITED STATES Albert Mousad, BS, UNITED STATES Stephen Le Breton, BS, UNITED STATES Glen Ross, MD, UNITED STATES Sarav Shah, MD, UNITED STATES
Influence of the Pattern of Rotator Cuff Tear in the Stability Obtained After Arthroscopic Superior Capsular Reconstruction: A Computational Analysis ePoster Presentation Madalena João Antunes, MEng, PORTUGAL Carlos Quental, PhD, Prof., PORTUGAL João Folgado, PhD, Prof., PORTUGAL Clara Azevedo, MD, PhD, PORTUGAL Ana Catarina Ângelo, MD, PORTUGAL

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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