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Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

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Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

Daichi Morikawa, MD, PhD, JAPAN Yoshimasa Saigo, MD, JAPAN Hirohisa Uehara, MD, JAPAN Yasutaka Yoshimura, MD, JAPAN Yoshiaki Itoigawa, MD, PhD, JAPAN Hironori Tsurukami, MD, JAPAN Fumitoshi Hatae, MD, JAPAN Muneaki Ishijima, MD, PhD, JAPAN

Juntendo University, Hongo, Tokyo, JAPAN

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Anatomic Location

Shoulder Rotator Cuff

Diagnosis / Condition

Tears

Treatment / Technique

Arthroscopy

Diagnosis Method

MRI

Summary: Arthroscopic superior capsular reconstruction using long head biceps with rotator cuff repair may increase tendon healing and clinical outcomes to reduce stress of repaired tendon.

Purpose

Recently, arthroscopic superior capsule reconstructions (ASCR) using the long head of the biceps (LHB) tendon were reported. However, there were several variations for fixing method of LHB and few comparative studies. We performed ASCR using LHB to decrease superior migration of humeral head and LHB tenodesis to intertubercular groove to decrease possibility of postoperative pain for large to massive rotator cuff tear. The purpose of this study was to compare the clinical outcomes and re-tear rate between ASCR using LHB with RCR and ARCR in large to massive rotator cuff tear.
[Subjects and Methods] We performed a retrospective review of consecutive large to massive rotator cuff repair between January 2021 and March 2023. This study included 20 patients. If patients had intact or complete ruptured LHB tendon, we performed ARCR (Group-A: 13 cases). If patients had degenerated and dislocated LHB tendon, we performed SCR using LHB and tenodesis with ARCR (Group-B: 7 case). We reviewed patient’s characteristics (Age, sex, left/right, and dominant) and analyzed clinical outcomes including active range of motion (ROM. Anterior elevation (AE), external rotation (ER), internal rotation) and University of California at Los Angeles (UCLA) and Japanese Orthopaedic Association (JOA) scores before and 3, 6, and 12 months after surgery. For imaging evaluation, we check MRI before and 6 months after surgery to evaluate tear size, cuff integrity, re-tear date, atrophy of the rotator cuff muscles, and the status of the postoperative LHB tendon.

Results

There were no significant differences between the two groups in patient’s characteristics, preoperative tear size, rotator cuff muscle atrophy, ROMs, and clinical scores. In both two groups, the clinical outcomes and ROMs of AE and ER, and JOA and UCLA scores were significantly improved 12 months after surgery compared to preoperative. No significant differences in all clinical outcomes were observed between the two groups. Re-tears were observed in 5 cases (38.5%) in group A, 1 of which underwent reoperation (RSA), no re-tear was observed in Group-B. However, re-tear rates were not significantly differenced (p=0.1). No rupture was observed in postoperative LHB tendon.

Discussion

and conclusions] ASCR using LHB with RCR may increase tendon healing and clinical outcomes to reduce stress of repaired tendon.

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Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

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Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

Clinical Outcomes of Arthroscopic Superior Capsular Reconstruction Using Long Head of the Biceps With Rotator Cuff Repair

Purpose

Results

Discussion