Arthroscopic Superior Capsule Reconstruction Using Autologous Fascia Lata and Biceps Tendon Augmentation

Abstract

Whereas arthroscopic superior capsule reconstruction has recently been introduced to treat irreparable rotator cuff tears with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to introduce a modified arthroscopic technique using the long head of the biceps tendon as augmentation for superior capsule reconstruction with fascia lata autograft.

Arthroscopic Superior Capsule Reconstruction With Fascia Lata Autograft And In-Situ Biceps Tendon Augmentation: Feasible Outcomes After Minimum Two-Year Follow-Up

“…All the surgery was performed with patients under general anesthesia and based on a previously described surgical technique. 14 Autologous FL graft of 5 × 15 cm 2 in size was harvested from lateral thigh with the patient in lateral decubitus position. After suture approximation and proper dressing of the donor site, the patient was changed to beach-chair position.…”

“…Posterior border of graft patch and residual infraspinatus were closed with Ethibond suture for full coverage of the rotator cuff defect. 14 After wound closure with 3-0 nylon, an abduction pillow brace was applied to keep the shoulder in 45° abduction.

Figure 1 Drawing picture of superior capsule reconstruction using fascia lata graft and biceps tendon augmentation in the right shoulder with irreparable rotator cuff tear.

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“…Posterior border of graft patch and residual infraspinatus were closed with Ethibond suture for full coverage of the rotator cuff defect. 14 After wound closure with 3-0 nylon, an abduction pillow brace was applied to keep the shoulder in 45 abduction.…”

“…There were no perioperative infection, neurovascular injury or donor site complications in all 18 patients. The MCID calculated using the anchor method was 20.1 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) for ASES, 10.9 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) for UCLA, 20.2 (11.3-36.4) for QuickDASH, 34.3 (20-50) for SANE, and 1.6 (0-3) for VAS pain. The PASS, calculated from satisfaction anchors was 82.4 (71-88) for ASES, 21.1 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25) for UCLA, 26 (18.2-31.8) for QuickDASH, 82.4 (70-90) for SANE, and 1.7 (0-3) for VAS pain score.…”

“…Therefore we followed a modified technique of SCR using FL autograft and in situ LHBT augmentation. 14 The purpose of this study was to investigate the preliminary functional and radiographic outcomes after arthroscopic SCR with LHBT augmentation for irreparable RCTs. We hypothesized that LHBT could serve as a useful augment in SCR using FL autograft to achieve feasible clinical and radiographic results after primary outcome survey.…”