These authors, including the originator of the procedure, assessed the 5 year functional and radiographic results of superior capsule reconstruction performed on 30 patients with irreparable cuff tears using fascia lata autograft.
Compared with preoperative values, ASES and JOA scores, active elevation, and acromiohumeral distance increased postoperatively at both 1 year (p < 0.001) and 5 years (p < 0.001).
The 1-year values increased by 54.0 points for the ASES score, 34.4 points for the JOA score, 53° for active elevation, and 5.7 mm for acromiohumeral distance,
The 5-year values increased by 63.3 points for the ASES score, 39.9 points for the JOA score, 66° for active elevation, and 4.7 mm for acromiohumeral distance. The ASES score was greater at 5 years postoperatively than it was at 1 year postoperatively (mean difference, 9.3 points; p = 0.03). At 5 years postoperatively, 11 of 12 patients returned to physical work, a rate of 92% (95% confidence interval [CI], 73% to 100%), and 8 of 8 patients returned to sports, a rate of 100% (95% CI, 79% to 100%).
None of the 27 patients who had graft healing showed progression of cuff tear arthropathy, but all 3 patients with a graft tear (10% [95% CI, 0% to 22%]) had severe cuff tear arthropathy at 5 years postoperatively.
In the 27 patients whose grafts remained intact, the graft thicknesses at 3 months, 1 year, and 5 years postoperatively did not differ (p = 0.67).
Comment: These authors emphasize the value of using a thick (8-9mm) fascia lata autograft (as shown in the figure below) to optimize healing, durability and the subacromial spacer effect of the graft.
Finally, they caution that their results with thick fascia lata allograft cannot be extrapolated to the use of thinner dermal allograft.
==
A video of our approach to shoulders with irreparable cuff tears can be seen by clicking this link.
=====
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
