These authors, including the originator of the SCR, reviewed their two year minimum outcomes in 35 shoulders having arthroscopic superior capsule reconstruction with Teflon felt synthetic 1 graft for irreparable massive rotator cuff tears:
They reported that SCR using Teflon grafts of either one or three layers significantly improved
the ASES score by 21, for one-layer graft; and by 31 for three-layer graft.
the VAS score for motion pain by 3.2, and by 3.0.
and muscle strength in shoulder abduction by 11.9 N, and by 10.9 N,
Active elevation at final follow-up was significantly greater in the three-layer-graft group (142° ± 27°) than in the one-layer-graft group (107° ± 42°) (P = 0.006).
One year after SCR, the acromiohumeral distance in the three-layer-graft group was significantly greater than preoperatively, whereas in the one-layer-graft group it was not. The acromiohumeral distance diminished with time.
On postoperative MRI, none of the patients in the three-layer-graft group had graft tears, while two patients had graft tear and one patient had severe synovitis after one-layer-graft SCR.
Comment: It is of interest that up to now the materials used for SCR have included biological autogenous fascia lata, biological acellular dermal matrix (GraftJacket, ArthroFlex ® SCR), and now the non-biological Teflon graft.
Another issue is that the preoperative active elevation (flexion) for the shoulders treated ranged from 20 to 160 degrees. This is a huge variation. Shoulders with retained active elevation can be well managed with simpler, safer, and less expensive procedures than a SCR (see this link).
In order to understand the value (effectiveness divided by the cost) of the growing number of different approaches to the irreparable cuff we will need higher quality studies that accurately characterize the preoperative to postoperative change for each patient, stratified by their preoperative shoulder function and pathology.
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