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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Article info
Publication history
Accepted:
December 30,
2022
Received in revised form:
December 14,
2022
Received:
May 20,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This study was approved by the Institutional Review Board of Gil Medical Center, Gachon University (GAIRB2022-027).
The authors, their immediate families, or any research foundations with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
Identification
Copyright
© 2023 Published by Elsevier on behalf of the Arthroscopy Association of North America
