Cost comparison and complication profiles of superior capsular reconstruction, lower trapezius transfer, and reverse shoulder arthroplasty for irreparable rotator cuff tears

Anterior Cable Reconstruction Using Autologous Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears

“…Donor site morbidity, immune reactions, case complexity, and cost of procedures have also reinvigorated interest in the long head of the biceps as a source of autologous tissue (Veen, Stevens, and Diercks 2018). A recent retrospective review showed SCR to have a significant additional cost of $3,922 compared to lower trapezius transfer and RTSA (Marigi et al 2022). The subacromial spacer, despite early promising results (Savarese and Romeo 2012;Familiari et al 2021), may not be the best option either, given the cost and recent level I evidence demonstrating its inferiority to debridement alone (Metcalfe et al 2022) and non-superiority when compared to partial repair (Verma et al 2022).…”

The Number of Surgeons Using Superior Capsular Reconstruction for Rotator Cuff Repair Is Declining

“…As reported in the literature and by arthroscopic respondents, the cost of SCR presents a socioeconomic issue that often effects decision-making. 36 In addition, some reports emphasize that less complex and costly procedures are reasonable options to initially address a massive RC tear, especially as a primary procedure, such as partial repair that has some literature reporting only 5% of patients necessitating revision or reoperation. 37 That being said, many patients with massive irreparable tears do not always do well with partial repair, hence why this is still a clinical dilemma for many patients and surgeons.…”

Editorial Commentary: Determination of Meaningful, Clinically Significant Outcome Thresholds for Superior Capsular Reconstruction of the Shoulder: Predicting Those Patients Who Improve and Those Who Don’t!

“…16 Therefore, stratification of short-to mid-term clinical success, rather than radiographic continuity, is important to substantiate allocation of health care costs relative to other alternatives, such as tendon transfer or reverse total shoulder arthroplasty. 17 Despite the failure of conservative measures and/or primary rotator cuff interventions, the authors show that approximately 2 of 3 patients will experience noticeable improvement in their condition after SCR, and close to 50% will express satisfaction in shoulder pain and function at nearly 2-year follow-up. Based on the current study, surgeons should exercise caution in recommending SCR for patients of advancing chronological age and significant subscapularis involvement, particularly if irreparable or untreated.…”