All Knot-less Arthroscopic Superior Capsular Reconstruction

Anderson, Shane; Trenhaile, Scott W.

doi:10.1016/j.eats.2018.03.019

Cited by 10 publications

(17 citation statements)

References 5 publications

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“… 1 , 8 , 13 , 14 , 15 , 16 Nine technical reviews without clinical outcomes were identified by the search. 6 , 7 , 17 , 18 , 19 , 20 , 21 , 22 , 23 One study with clinical outcomes was excluded because the number of patients with each type of graft was not mentioned. 24 The same authors, Mihata et al., 3 , 15 , 25 published 3 papers at 3 different times on the same study population.…”

Section: Resultsmentioning

confidence: 99%

Superior Capsular Reconstruction: Fascia Lata Versus Acellular Dermal Allograft: A Systematic Review

Abdelrahman

Sobhy

Abdelazim

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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We systematically reviewed the literature to compare the clinical and radiologic outcomes and retear rates of superior capsular reconstruction (SCR) using fascia lata autograft (FLA) versus human dermal allograft (HDA) in cases of massive irreparable rotator cuff tears. Methods: Searches of Pub Med and Cochrane Library identified clinical studies addressing SCR using FLA and HDA. Two reviewers independently screened the titles, abstracts and full texts to extract data from eligible studies. Reported outcome measures were descriptively analyzed. Results: A total of 6 studies with 2 study groups satisfied the inclusion criteria. The number of shoulders in the HDA group was 155, and in the FLA group, the number was 140 shoulders. The mean age at time of surgery for the HDA group and the FLA group was 60.49 years and 65.8 years, respectively, and the mean follow-up was 15.2 months and 44.6 months, respectively. Active elevation improved from of 121-130 to 158-160 in the HDA group and from 74.8-133 to 130.4-146 in the FLA group. Active external rotation improved from 36-45 in the HDA group and from 13-28 to 30-43 in the FLA group. The Visual Analog Scale for pain improved from 4-6.25 to 0.38-1.7 points in the HDA group, whereas in the FLA group, it improved from 6-2.5 points. In the HDA group, American Shoulder and Elbow Surgeons scores improved from 42-52 to 77.5-86.5, whereas in the FLA group scores improved from 35-54.4 to 73.7-94.3. The acromiohumeral distance improved in both groups. The retear rate was 3.4%-55% in the HDA group and 4.5%-29% % in the FLA group. Conclusions: Arthroscopic SCR for massive, irreparable rotator cuff tears using both fascia lata allograft and human dermal allograft leads to improvement in clinical outcomes and radiologic outcomes. There is a lower retear rate in fascia lata allografts. The current literature is heterogeneous and has low levels of evidence. Level of Evidence: Level IV, systematic review of level IV studies.

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Section: Resultsmentioning

confidence: 99%

Superior Capsular Reconstruction: Fascia Lata Versus Acellular Dermal Allograft: A Systematic Review

Abdelrahman

Sobhy

Abdelazim

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Some surgeons prefer to pass the graft before passing any sutures, while others prefer to pass the sutures through the graft outside the patient and then shuttle the graft through a cannula. After passage into the joint, the graft is secured using either a knotless technique or by tying knots 4, 5…”

Section: Discussionmentioning

confidence: 99%

A Technique Using an Easy-to-Fabricate Cannula to Manage Sutures and Aid Graft Passage in Arthroscopic Superior Capsular Reconstruction

Rashid

Novak²,

et al. 2019

Arthroscopy Techniques

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Arthroscopic superior capsular reconstruction has become a popular technique used to restore shoulder function in superior cuff deficiency. Passage of the graft via the portal sites is prone to entanglement with sutures and graft twisting. To make shuttling of the graft easier, and reduce the risk of suture entanglement, we developed a technique involving fabricating a suture management cannula from a simple sterile 10-mL syringe. The benefits of this technique are that it allows multiple sutures to be managed easily, avoiding entanglement of the graft during passage and attachment.

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“…Ten studies advocated for the immediate implementation of passive ROM exercises after surgery. [2][3][4]6,[8][9][10][16][17][18] The other 4 studies emphasized waiting 2 to 8 weeks after surgery or after sling/ brace removal. 1,[13][14][15] Boutsiadis et al 4 were the only authors to specify a precise time point of 15 days after surgery in order to start any passive ROM of shoulder.…”

Section: Phase Two: Passive Rommentioning

confidence: 99%

“…1 Although the procedure is fairly novel, multiple studies have demonstrated positive outcomes despite differences in surgical nuances. 1,4,[6][7][8][9][10] The postoperative rehabilitation protocol is an important component for a successful result. For SCR, although there is literature discussing the different variations of the procedure, there is no literature comparing postoperative rehabilitation protocols.…”

mentioning

confidence: 99%

“…In response, superior capsular reconstruction (SCR) 5 has been recommended as a joint-sparing treatment for irreparable RCTs. 6 SCR prevents translation of the humeral head and improves biomechanical stability and force coupling of the remaining cuff. 1 Although the procedure is fairly novel, multiple studies have demonstrated positive outcomes despite differences in surgical nuances.…”

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confidence: 99%

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Rehabilitation Protocols for Superior Capsular Reconstruction Are Variable: A Systematic Review

Lavin

Mansour

Greif

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To screen manuscripts that discuss rehabilitation protocols for patients who underwent superior capsular reconstruction (SCR) to elucidate whether a standard rehabilitation algorithm exists for SCR. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (i.e., PRISMA) guidelines. PubMed (MEDLINE) and Embase were searched using pertinent Boolean operation terms "superior capsular reconstruction" and "rotator cuff repair rehabilitation," and articles that included rehabilitation protocols following superior capsular reconstruction surgery were reviewed. Two independent reviewers performed the search and quality assessment. Results: A total of 549 articles were yielded after our database search. Fourteen studies fulfilled our inclusion criteria and were included in the review. Study designs included 9 editorials, 3 case series, and 2 case reports. Each study included in this review used a unique rehabilitation algorithm that posed significant variability between the protocols. Four phases were identified to summarize each protocol and were used as a basis of discussiondsling versus brace time (3-6 weeks for comfort/removal vs complete immobilization), passive range of motion (immediately after surgery to initiation at 6 weeks), active range of motion (4-8 weeks), and strengthening/return to full activity (12-52 weeks). Initiation of rehabilitation, length of time spent in each phase, types of exercises, and overarching goals for return to function were significantly variable and were decided upon by the surgeon based on current massive rotator cuff repair protocols. Presently, there is no standard rehabilitation protocol for SCR. Conclusions: SCR is a relatively new procedure that is gaining rapid popularity with promising outcomes. Based on our review, there is no standard rehabilitation protocol in place; thus, it is not possible to recommend an evidence-based rehabilitation protocol following SCR at this time. Level of Evidence: Level V, systematic review of Level IV and V studies.

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All Knot-less Arthroscopic Superior Capsular Reconstruction

Cited by 10 publications

References 5 publications

Superior Capsular Reconstruction: Fascia Lata Versus Acellular Dermal Allograft: A Systematic Review

Superior Capsular Reconstruction: Fascia Lata Versus Acellular Dermal Allograft: A Systematic Review

A Technique Using an Easy-to-Fabricate Cannula to Manage Sutures and Aid Graft Passage in Arthroscopic Superior Capsular Reconstruction

Rehabilitation Protocols for Superior Capsular Reconstruction Are Variable: A Systematic Review

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