Superior capsular reconstruction with autologous fascia lata using single lateral row technique is an effective option in massive irreparable rotator cuff tears. Minimum two-year follow-up.

Abstract

PURPOSE\nThe purpose of this study is to evaluate clinical and radiological outcomes of arthroscopic superior capsular reconstruction (ASCR) with fascia lata autograft in patients with irreparable rotator cuff tears (IRCT) performed with a single lateral row fixation technique.\n\n\nMETHODS\nRetrospective case series of patients with large or massive IRCTs for ASCR with fascia lata autograft. Clinical outcomes were evaluated with visual analog scale (VAS) and Constant Score. Healing of the graft was assessed with MRI or ultrasound. Acromio-humeral distance was evaluated with X-rays.\n\n\nRESULTS\nThirty-one patients with an average age of 61 years and average follow-up of 35 months (from 24 to 51 months) underwent ASCR with fascia lata autograft. There was a significant improvement in VAS (from 7.7 to 0.7), Constant Score (from 36.0 to 78.7), forward elevation (from 115° to 171°), external rotation (from 33° to 50), strength (from 0.3kg to 2.3kg), and acromio-humeral distance (from 6.1 mm to 8.6 mm)(p<0.001). Graft failure was present in 13.8% of patients, as shown by MRI (26 patients) or ultrasound (3 patients). Patients with failed ASCR showed worse Constant Scores (68.5.8 vs 80.2, p=0.007), worse VAS (2.5 vs 0.4, p=0.00002), worse external rotation (20° vs 54°, p=0.004), lower acromio-humeral distance (5mm vs 9mm, p=0.007) and a high association with the presence of Os Acromiale (chi2 p=0.003). No revision or subsequent surgical procedures were required.\n\n\nCONCLUSIONS\nASCR, with autologous fascia lata and single lateral row configuration, is an effective option in irreparable rotator cuff tears, with clinical and radiological improvement.