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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2023

20-06-2023 | Painful Arc | Shoulder

Superior capsular reconstruction using the long head of the biceps to treat massive rotator cuff tears improves patients shoulder pain, mobility and function

Authors: Qiuming Gao, Yue Qiao, Yonghao Guan, Yiwei Zhang, Tianyang Xu, Zhengwei Duan, Lin Fan, Zihua Li, Guodong Li, Jian Sun

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2023

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Abstract

Purpose

Arthroscopic superior capsule reconstruction (SCR) with the long head of the biceps (LHBT) was performed to restore structural stability, force couple balance, and shoulder joint function. This study aimed to evaluate the functional outcomes of SCR using the LHBT over at least 24 months of follow-up.

Method

This retrospective study included 89 patients with massive rotator cuff tears who underwent SCR using the LHBT, met the inclusion criteria and underwent follow up for at least 24 months. The preoperative and postoperative shoulder range of motion (forward flexion, external rotation, and abduction), acromiohumeral interval (AHI), visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score and Constant–Murley score were obtained, and the tear size, and Goutallier and Hamada grades were also investigated.

Results

Compared with those measured preoperatively, the range of motion, AHI, and VAS, Constant–Murley, and ASES scores were significantly improved immediately postoperatively (P < 0.001) and at the 6-month, 12-month, and final follow-ups (P < 0.001). At the last follow-up, the postoperative ASES score and Constant-Murley score increased from 42.8 ± 7.6 to 87.4 ± 6.1, and 42.3 ± 8.9 to 84.9 ± 10.7, respectively; with improvements of 51 ± 21.7 in forward flexion, 21.0 ± 8.1 in external rotation, and 58.5 ± 22.5 in abduction. The AHI increased 2.1 ± 0.8 mm and the VAS score significantly changed from 6.0 (5.0, 7.0) to 1.0 (0.0, 1.0), at the final follow-up. Eleven of the 89 patients experienced retears, and one patient needed reoperation.

Conclusion

In this study with at least 24-months of follow-up, SCR using the LHBT for massive rotator cuff tears could effectively relieve shoulder pain, restore shoulder function and increase shoulder mobility to some extent.

Level of evidence

IV.
Literature
1.
go back to reference Berthold DP, Muench LN, Dyrna F, Scheiderer B, Obopilwe E, Cote MP et al (2021) Comparison of different fixation techniques of the long head of the biceps tendon in superior capsule reconstruction for irreparable posterosuperior rotator cuff tears: a dynamic biomechanical evaluation. Am J Sports Med 49:305–313CrossRefPubMed Berthold DP, Muench LN, Dyrna F, Scheiderer B, Obopilwe E, Cote MP et al (2021) Comparison of different fixation techniques of the long head of the biceps tendon in superior capsule reconstruction for irreparable posterosuperior rotator cuff tears: a dynamic biomechanical evaluation. Am J Sports Med 49:305–313CrossRefPubMed
2.
go back to reference Böhm E, Gleich J, Siebenbürger G, Böcker W, Ockert B (2021) Rotator cuff tear: indications and pathology-specific reconstructive procedures. Unfallchirurg 124:108–116CrossRefPubMed Böhm E, Gleich J, Siebenbürger G, Böcker W, Ockert B (2021) Rotator cuff tear: indications and pathology-specific reconstructive procedures. Unfallchirurg 124:108–116CrossRefPubMed
3.
go back to reference Boutsiadis A, Chen S, Jiang C, Lenoir H, Delsol P, Barth J (2017) Long head of the biceps as a suitable available local tissue autograft for superior capsular reconstruction: “The Chinese Way.” Arthrosc Tech 6:e1559–e1566CrossRefPubMedPubMedCentral Boutsiadis A, Chen S, Jiang C, Lenoir H, Delsol P, Barth J (2017) Long head of the biceps as a suitable available local tissue autograft for superior capsular reconstruction: “The Chinese Way.” Arthrosc Tech 6:e1559–e1566CrossRefPubMedPubMedCentral
4.
go back to reference Denard PJ, Brady PC, Adams CR, Tokish JM, Burkhart SS (2018) Preliminary results of arthroscopic superior capsule reconstruction with dermal allograft. Arthroscopy 34:93–99CrossRefPubMed Denard PJ, Brady PC, Adams CR, Tokish JM, Burkhart SS (2018) Preliminary results of arthroscopic superior capsule reconstruction with dermal allograft. Arthroscopy 34:93–99CrossRefPubMed
5.
go back to reference Di Benedetto P, Mancuso F, Tosolini L, Buttironi MM, Beltrame A, Causero A (2021) Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed 92:e2021026PubMedPubMedCentral Di Benedetto P, Mancuso F, Tosolini L, Buttironi MM, Beltrame A, Causero A (2021) Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed 92:e2021026PubMedPubMedCentral
6.
go back to reference El-Shaar R, Soin S, Nicandri G, Maloney M, Voloshin I (2018) Superior capsular reconstruction with a long head of the biceps tendon autograft: a cadaveric study. Orthop J Sports Med 6:2325967118785365CrossRefPubMedPubMedCentral El-Shaar R, Soin S, Nicandri G, Maloney M, Voloshin I (2018) Superior capsular reconstruction with a long head of the biceps tendon autograft: a cadaveric study. Orthop J Sports Med 6:2325967118785365CrossRefPubMedPubMedCentral
7.
go back to reference Elmorsy S, Tang QO, Tayyem M, Amirthanayagam T, Ravenscroft M, Makki D (2021) Arthroscopic superior capsular reconstruction for management of massive irreparable rotator cuff tears: a simple alternative technique. Orthopedics 44:e458–e462CrossRefPubMed Elmorsy S, Tang QO, Tayyem M, Amirthanayagam T, Ravenscroft M, Makki D (2021) Arthroscopic superior capsular reconstruction for management of massive irreparable rotator cuff tears: a simple alternative technique. Orthopedics 44:e458–e462CrossRefPubMed
8.
go back to reference Everts PA, van Erp A, DeSimone A, Cohen DS, Gardner RD (2021) Platelet rich plasma in orthopedic surgical medicine. Platelets 32:163–174CrossRefPubMed Everts PA, van Erp A, DeSimone A, Cohen DS, Gardner RD (2021) Platelet rich plasma in orthopedic surgical medicine. Platelets 32:163–174CrossRefPubMed
9.
go back to reference Galasso O, Mantovani M, Muraccini M, Berardi A, De Benedetto M, Orlando N et al (2020) The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 28:2367–2376CrossRefPubMed Galasso O, Mantovani M, Muraccini M, Berardi A, De Benedetto M, Orlando N et al (2020) The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 28:2367–2376CrossRefPubMed
10.
go back to reference Greenspoon JA, Petri M, Warth RJ, Millett PJ (2015) Massive rotator cuff tears: pathomechanics, current treatment options, and clinical outcomes. J Shoulder Elbow Surg 24:1493–1505CrossRefPubMed Greenspoon JA, Petri M, Warth RJ, Millett PJ (2015) Massive rotator cuff tears: pathomechanics, current treatment options, and clinical outcomes. J Shoulder Elbow Surg 24:1493–1505CrossRefPubMed
11.
go back to reference Guo J, Long Y, Zhou M, He ZH, Zeng WK, Yu ML et al (2022) H-loop knotless double-row repair versus knotted suture bridge for rotator cuff tears: a biomechanical and histological study in an animal model [formula: see text]. Am J Sports Med 50:1948–1959CrossRefPubMed Guo J, Long Y, Zhou M, He ZH, Zeng WK, Yu ML et al (2022) H-loop knotless double-row repair versus knotted suture bridge for rotator cuff tears: a biomechanical and histological study in an animal model [formula: see text]. Am J Sports Med 50:1948–1959CrossRefPubMed
12.
go back to reference Howard MC, Waterman BR (2022) Editorial commentary: predictors of best outcomes after latissimus dorsi transfer for irreparable rotator cuff tear. Arthroscopy 38:1831–1833CrossRefPubMed Howard MC, Waterman BR (2022) Editorial commentary: predictors of best outcomes after latissimus dorsi transfer for irreparable rotator cuff tear. Arthroscopy 38:1831–1833CrossRefPubMed
13.
go back to reference Kovacevic D, Suriani RJ Jr, Grawe BM, Yian EH, Gilotra MN, Hasan SA et al (2020) Management of irreparable massive rotator cuff tears: a systematic review and meta-analysis of patient-reported outcomes, reoperation rates, and treatment response. J Shoulder Elbow Surg 29:2459–2475CrossRefPubMedPubMedCentral Kovacevic D, Suriani RJ Jr, Grawe BM, Yian EH, Gilotra MN, Hasan SA et al (2020) Management of irreparable massive rotator cuff tears: a systematic review and meta-analysis of patient-reported outcomes, reoperation rates, and treatment response. J Shoulder Elbow Surg 29:2459–2475CrossRefPubMedPubMedCentral
15.
go back to reference Lapner P, Henry P, Athwal GS, Moktar J, McNeil D, MacDonald P (2022) Treatment of rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg 31:e120–e129CrossRefPubMed Lapner P, Henry P, Athwal GS, Moktar J, McNeil D, MacDonald P (2022) Treatment of rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg 31:e120–e129CrossRefPubMed
16.
go back to reference Li X, Shen P, Su W, Zhao S, Zhao J (2018) Into-tunnel repair versus onto-surface repair for rotator cuff tears in a rabbit model. Am J Sports Med 46:1711–1719CrossRefPubMed Li X, Shen P, Su W, Zhao S, Zhao J (2018) Into-tunnel repair versus onto-surface repair for rotator cuff tears in a rabbit model. Am J Sports Med 46:1711–1719CrossRefPubMed
17.
go back to reference Longo UG, Carnevale A, Piergentili I, Berton A, Candela V, Schena E et al (2021) Retear rates after rotator cuff surgery: a systematic review and meta-analysis. BMC Musculoskelet Disord 22:749CrossRefPubMedPubMedCentral Longo UG, Carnevale A, Piergentili I, Berton A, Candela V, Schena E et al (2021) Retear rates after rotator cuff surgery: a systematic review and meta-analysis. BMC Musculoskelet Disord 22:749CrossRefPubMedPubMedCentral
18.
go back to reference Ma L, Xu Y, Xu X, Pan Q, Xu Y (2021) Application of biomimetic double-layer biofilm stent in arthroscopic rotator cuff repair: a protocol of randomized controlled trial. Medicine (Baltimore) 100:e23960CrossRefPubMed Ma L, Xu Y, Xu X, Pan Q, Xu Y (2021) Application of biomimetic double-layer biofilm stent in arthroscopic rotator cuff repair: a protocol of randomized controlled trial. Medicine (Baltimore) 100:e23960CrossRefPubMed
19.
go back to reference Makovicka JL, Chung AS, Patel KA, Deckey DG, Hassebrock JD, Tokish JM (2020) Superior capsule reconstruction for irreparable rotator cuff tears: a systematic review of biomechanical and clinical outcomes by graft type. J Shoulder Elbow Surg 29:392–401CrossRefPubMed Makovicka JL, Chung AS, Patel KA, Deckey DG, Hassebrock JD, Tokish JM (2020) Superior capsule reconstruction for irreparable rotator cuff tears: a systematic review of biomechanical and clinical outcomes by graft type. J Shoulder Elbow Surg 29:392–401CrossRefPubMed
20.
go back to reference Mihata T, Lee TQ, Hasegawa A, Kawakami T, Fukunishi K, Fujisawa Y et al (2018) Arthroscopic superior capsule reconstruction can eliminate pseudoparalysis in patients with irreparable rotator cuff tears. Am J Sports Med 46:2707–2716CrossRefPubMed Mihata T, Lee TQ, Hasegawa A, Kawakami T, Fukunishi K, Fujisawa Y et al (2018) Arthroscopic superior capsule reconstruction can eliminate pseudoparalysis in patients with irreparable rotator cuff tears. Am J Sports Med 46:2707–2716CrossRefPubMed
21.
go back to reference Pennington WT, Bartz BA, Pauli JM, Walker CE, Schmidt W (2018) Arthroscopic superior capsular reconstruction with acellular dermal allograft for the treatment of massive irreparable rotator cuff tears: short-term clinical outcomes and the radiographic parameter of superior capsular distance. Arthroscopy 34:1764–1773CrossRefPubMed Pennington WT, Bartz BA, Pauli JM, Walker CE, Schmidt W (2018) Arthroscopic superior capsular reconstruction with acellular dermal allograft for the treatment of massive irreparable rotator cuff tears: short-term clinical outcomes and the radiographic parameter of superior capsular distance. Arthroscopy 34:1764–1773CrossRefPubMed
22.
go back to reference Pogorzelski J, Rupp MC, Scheiderer B, Lacheta L, Schliemann B, Schanda J et al (2023) Management of irreparable posterosuperior rotator cuff tears-a current concepts review and proposed treatment algorithm by the AGA shoulder committee. J Pers Med 13:191CrossRefPubMedPubMedCentral Pogorzelski J, Rupp MC, Scheiderer B, Lacheta L, Schliemann B, Schanda J et al (2023) Management of irreparable posterosuperior rotator cuff tears-a current concepts review and proposed treatment algorithm by the AGA shoulder committee. J Pers Med 13:191CrossRefPubMedPubMedCentral
23.
go back to reference Preuss FR, Day HK, Peebles AM, Mologne MS, Provencher MT (2022) Reverse total shoulder arthroplasty for treatment of massive, irreparable rotator cuff tear. Arthrosc Tech 11:e1133–e1139CrossRefPubMedPubMedCentral Preuss FR, Day HK, Peebles AM, Mologne MS, Provencher MT (2022) Reverse total shoulder arthroplasty for treatment of massive, irreparable rotator cuff tear. Arthrosc Tech 11:e1133–e1139CrossRefPubMedPubMedCentral
24.
go back to reference Saithna A (2021) Editorial commentary: human dermal allograft is preferable to fascia lata autograft based on similar outcomes without donor-site morbidity. Arthroscopy 37:2797–2799CrossRefPubMed Saithna A (2021) Editorial commentary: human dermal allograft is preferable to fascia lata autograft based on similar outcomes without donor-site morbidity. Arthroscopy 37:2797–2799CrossRefPubMed
25.
go back to reference Schneider MM, Moursy M, Gerhardt C, Kimmeyer M, Rentschler V, Lehmann LJ (2022) Latissimus dorsi transfer with a modified single-incision Herzberg technique and description of its arthroscopic advancement. Oper Orthop Traumatol 34:55–70CrossRefPubMed Schneider MM, Moursy M, Gerhardt C, Kimmeyer M, Rentschler V, Lehmann LJ (2022) Latissimus dorsi transfer with a modified single-incision Herzberg technique and description of its arthroscopic advancement. Oper Orthop Traumatol 34:55–70CrossRefPubMed
26.
go back to reference Smith GC, Im HY, Lam PH (2022) Effect of human dermal allograft thickness on glenohumeral stability for superior capsular reconstruction in irreparable supraspinatus tears: a biomechanical analysis of the superior capsular reconstruction—a cadaveric study. Shoulder Elbow 14:31–37CrossRefPubMed Smith GC, Im HY, Lam PH (2022) Effect of human dermal allograft thickness on glenohumeral stability for superior capsular reconstruction in irreparable supraspinatus tears: a biomechanical analysis of the superior capsular reconstruction—a cadaveric study. Shoulder Elbow 14:31–37CrossRefPubMed
27.
go back to reference Vaudreuil NJ, Dooney T, Lee TQ, Limpisvasti O (2022) Shoulder surgeon techniques and preferences in treatment of massive rotator cuff tears: current practices for rotator cuff repair and superior capsule reconstruction. JSES Int 6:978–983CrossRefPubMedPubMedCentral Vaudreuil NJ, Dooney T, Lee TQ, Limpisvasti O (2022) Shoulder surgeon techniques and preferences in treatment of massive rotator cuff tears: current practices for rotator cuff repair and superior capsule reconstruction. JSES Int 6:978–983CrossRefPubMedPubMedCentral
28.
go back to reference Wieser K, Ernstbrunner L, Zumstein MA (2020) Surgical management of massive irreparable cuff tears: latissimus dorsi transfer for posterosuperior tears. Curr Rev Musculoskelet Med 13:605–611CrossRefPubMedPubMedCentral Wieser K, Ernstbrunner L, Zumstein MA (2020) Surgical management of massive irreparable cuff tears: latissimus dorsi transfer for posterosuperior tears. Curr Rev Musculoskelet Med 13:605–611CrossRefPubMedPubMedCentral
31.
go back to reference Zhu J, Shao J, Chen Y, Zhao G, Li L, Fu Q et al (2021) Fibrin glue-kartogenin complex promotes the regeneration of the tendon-bone interface in rotator cuff injury. Stem Cells Int 2021:6640424CrossRefPubMedPubMedCentral Zhu J, Shao J, Chen Y, Zhao G, Li L, Fu Q et al (2021) Fibrin glue-kartogenin complex promotes the regeneration of the tendon-bone interface in rotator cuff injury. Stem Cells Int 2021:6640424CrossRefPubMedPubMedCentral
32.
go back to reference Zink TR, Schmidt CC, Papadopoulos DV, Blake RJ, Smolinski MP, Davidson AJ et al (2021) Locating the rotator cable during subacromial arthroscopy: bursal- and articular-sided anatomy. J Shoulder Elbow Surg 30:S57-s65CrossRefPubMed Zink TR, Schmidt CC, Papadopoulos DV, Blake RJ, Smolinski MP, Davidson AJ et al (2021) Locating the rotator cable during subacromial arthroscopy: bursal- and articular-sided anatomy. J Shoulder Elbow Surg 30:S57-s65CrossRefPubMed
Metadata
Title
Superior capsular reconstruction using the long head of the biceps to treat massive rotator cuff tears improves patients shoulder pain, mobility and function
Authors
Qiuming Gao
Yue Qiao
Yonghao Guan
Yiwei Zhang
Tianyang Xu
Zhengwei Duan
Lin Fan
Zihua Li
Guodong Li
Jian Sun
Publication date
20-06-2023
Publisher
Springer Berlin Heidelberg
Keyword
Painful Arc
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07489-7

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