Shoulder Superior Capsular Reconstruction Using Xenograft Shows No Deterioration in Functional Improvement at 5-Year...

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomaterials in Surgery

Background:

• Irreparable rotator cuff tears present a significant challenge in orthopedic surgery.
• Superior capsular reconstruction (SCR) offers a potential solution for restoring shoulder function.
• Xenografts, such as porcine dermal grafts, are utilized in SCR to address tendon defects.

Purpose of the Study:

• To evaluate the mid-term functional outcomes of superior capsular reconstruction using a porcine dermal graft.
• To assess radiographic shoulder findings and graft integrity at mid-term follow-up.
• To identify factors influencing functional outcomes after SCR for irreparable rotator cuff tears.

Main Methods:

• Retrospective case series of 23 patients (age ≤70) with chronic irreparable rotator cuff defects.
• Patients underwent xenograft SCR between October 2015 and January 2020.
• Clinical outcomes assessed using Constant score and WORC index; radiographic evaluation included MRI and Hamada classification at minimum 5-year follow-up.

Main Results:

• Twenty-one patients completed mid-term follow-up (mean 71 months).
• Significant improvements observed in Constant score (26 to 68) and WORC index (29% to 76%) (P < .001).
• 95% of patients exceeded minimal clinically important difference (MCID) for both scores; no correlation found between functional outcomes and radiographic findings or graft integrity.

Conclusions:

• Superior capsular reconstruction with porcine dermal grafts provides significant mid-term functional improvement for irreparable rotator cuff tears.
• The majority of patients achieve clinically meaningful outcomes, exceeding MCID thresholds.
• No correlation was identified between functional results and radiographic shoulder status at mid-term follow-up.