Simplified Technique for Superior Capsular Reconstruction Using an Acellular Dermal Allograft

Laskovski, Jovan R.; Boyd, Jason; Peterson, Eric E.; Abrams, Jeffrey S.

doi:10.1016/j.eats.2018.07.002

Cited by 18 publications

(28 citation statements)

References 10 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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“…Two glenoid anchors can be enough, although if the graft is >35 mm in the anterior-posterior dimension or the distance between the 2 glenoid anchors is >20 mm, a third anchor can be placed in the glenoid without increasing the risk of suprascapular nerve injury. 16,17 Since the original technique of Mihata et al 3 using a fascia lata, different grafts have been described for SCR. Dermal allograft has gained popularity for theitheoretical advantage of reducing donor site morbidity, shorter operative times, and easy preparation, although no clinical studies have confirmed the equivalence of the 2 grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Undertensioned grafts may not restore the superior stability of the glenohumeral joint, and overtensioned grafts may be at increased risk of tearing. 17 Biomechanical studies have investigated the appropriate tension of the graft and suggest that 45 of abduction is the best position to attach the graft, although more studies are required to know the best position for graft fixation and tension.…”

Section: Discussionmentioning

confidence: 99%

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A Lasso-Loop Traction Technique for Arthroscopic Superior Capsular Reconstruction

Aramberri-Gutiérrez¹,

Giovanni²,

Garcı́a-Dorado

et al. 2020

Arthroscopy Techniques

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Irreparable rotator cuff tears (RCTs) cause shoulder pain and disfunction. Management of RCT patients has classically been difficult due to few treatment options. Since Mihata et al. in 2013 introduced the superior capsular reconstruction (SCR) technique as a treatment option, it has become widespread among surgeons, especially for young active patients in whom reverse shoulder arthroplasty is not recommended. With SCR, a reduced humeral head can be maintained and superior displacement is avoided, improving shoulder pain and restoring active shoulder motion. A variety of grafts may be used, but the surgery can be technically complicated. An arthroscopic lasso-loop traction technique for SCR is described here, which simplifies graft shoulder reduction by traction from the anteromedial and posteromedial portals.

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“…Described posterior-based soft-tissue procedures are fewer but have included simultaneous anterior and posterior reconstruction with Achilles allograft 21 . Recently, an arthroscopic dermal allograft reconstruction procedure was described, 29 which is similar in concept to currently used superior capsular reconstruction techniques 30 …”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Posterior Glenohumeral Capsular Augmentation With Gracilis Tendon Allograft

Maloney

Schaffer

Kenney

2019

Arthroscopy Techniques

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Recurrent shoulder instability complicated by capsular insufficiency due to underlying soft-tissue disorders or multiple prior failed surgical procedures poses a challenging surgical problem. Traditional capsulolabral soft-tissue reconstruction techniques are less effective in this setting, and bony procedures sacrifice normal anatomic relations. The described arthroscopic technique aims to prevent instability while maintaining range of motion through creation of a soft-tissue allograft "sling" augmenting the posterior glenohumeral capsule.

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Simplified Technique for Superior Capsular Reconstruction Using an Acellular Dermal Allograft

Cited by 18 publications

References 10 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 Lasso-Loop Traction Technique for Arthroscopic Superior Capsular Reconstruction

Arthroscopic Posterior Glenohumeral Capsular Augmentation With Gracilis Tendon Allograft

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