Related Experiment Video
Updated: Jun 23, 2026
Modified Long Head of Biceps Tendon Rerouting and Fixation as Partial Capsular Reconstruction for Massive Irreparable Rotator Cuff Tears
Published on: March 6, 2026
Partial repair versus superior capsular reconstruction: comparable mid-term outcomes in non-pseudoparalytic massive
Berhan Bayram1, Muge Kirac2, Tahir Koray Yozgatli2
1Department of Orthopedics and Traumatology, Acibadem Altunizade Hospital, Istanbul, Turkey.
Hypothesis/Background:
Both partial rotator cuff repair (PRCR) and superior capsular reconstruction (SCR) are frequently performed arthroscopically to treat non-pseudoparalytic massive irreparable rotator cuff tears (MIRCT). The purpose of this study was to compare the clinical and radiological outcomes of PRCR and superior capsular reconstruction using tensor fascia latae autografts (SCRTF) in the treatment of non-pseudoparalytic MIRCT. The hypothesis was that both techniques would yield improved postoperative clinical and radiological outcomes with no significant difference between techniques.
Methods:
This retrospective comparative study included 40 patients (20 PRCR, 20 SCRTF) operated between 2017-2021. All patients were non-pseudoparalytic with at Goutallier grade 3 or greater fatty degeneration. Exclusion criteria were glenohumeral arthritis, cuff tear arthropathy, and pseudoparalysis. Clinical outcomes were assessed with VAS, ASES, and qDASH scores. Radiologic evaluation included measurement of the acromiohumeral distance (AHD). Pre- and postoperative values were compared within and between groups at a minimum of 32 months of follow-up.
Results:
Both groups demonstrated significant postoperative improvements in VAS, ASES, qDASH, and AHD compared with baseline (p<0.001). However, no statistically significant differences were observed between PRCR and SCRTF in clinical or radiological outcomes (p>0.05). Complications occurred in 3 patients (15%) in the SCRTF group (2 graft-site hematomas, one muscle herniation), whereas no complications were reported in the PRCR group; this difference was not statistically significant (p=0.23).
Conclusion:
Both PRCR and SCRTF provide satisfactory clinical and radiological outcomes in the treatment of non-pseudoparalytic MIRCT. While SCRTF carries a risk of graft-related complications, the overall effectiveness of both techniques appears comparable. For this reason, there might be no necessity to perform SCRTF in the treatment of non-pseudoparalytic MIRCT. Careful patient selection remains critical in optimizing outcomes.
Level Of Evidence:
Level III, retrospective comparative study.