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Arthroscopic Superior Capsular Reconstruction with Tensor Fascia Lata Allograft for Irreparable Rotator Cuff Tears: Clinical and Radiologic Outcomes for a Minimum 1-Year Follow-Up.

Published:January 14, 2023DOI:https://doi.org/10.1016/j.arthro.2022.12.037

      Abstract

      Purpose

      The purpose of this study was to confirm the radiological and clinical outcomes after performing arthroscopic superior capsular reconstruction (ASCR) using a tensor fascia lata (TFL) allograft.

      Methods

      Thirty-three patients with irreparable rotator cuff tears were treated with ASCR with a TFL allograft. The mean age and follow-up period were 62 years and 20.1 months, respectively. TFL allografts were used as 3, 4, and 6 layers, and the graft thickness was 3.7, 3.9, and 5.4 mm, respectively. Range of motion, visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, and Constant score were evaluated preoperatively and at the final follow-up. The pre-, postoperative, and final acromio-humeral distances (AHD) were compared. The graft integrity was checked through a follow-up MRI at least six months after surgery.

      Results

      Torn grafts were identified in 6 cases (19%). AHD significantly increased from 5.0 mm to 8.0 mm postoperatively (P<.0001). However, there was no significant difference of 5.0 mm at the final follow-up AHD. Five cases (83%) of torn grafts were induced in the three-layered graft sheet group, but the difference was not statistically significant (P=.025). VAS, forward elevation, internal rotation, ASES, and Constant scores significantly improved at the last follow-up. Two cases of early infection were confirmed and the graft materials were all removed.

      Conclusions

      Despite the possibility of early infection, ASCR using TFL allograft is a reliable procedure for the irreparable rotator cuff tear. In particular, if the number of layers of TFL allograft increases, it is judged that it could become a more effective graft.

      Level of Evidence

      Level IV, therapeutic case series

      Keywords

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