Both Rerouted and In Situ Biceps Superior Capsular Reconstruction Augmentation During Arthroscopic Rotator Cuff...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Reconstruction

Background:

• Rotator cuff tears are common, leading to pain and dysfunction.
• Superior capsular reconstruction (SCR) is an emerging technique for managing irreparable or complex rotator cuff tears.
• Utilizing the long head of the biceps tendon (LHBT) for SCR offers a biological augmentation option.

Purpose of the Study:

• To evaluate the 2-year clinical and radiologic outcomes of arthroscopic rotator cuff repair (RCR) augmented with superior capsular reconstruction (SCR) using the long head of the biceps tendon (LHBT).
• To compare outcomes between two different LHBT fixation techniques for SCR.

Main Methods:

• A retrospective, multicenter study included 58 patients with reparable posterosuperior rotator cuff tears.
• Patients underwent arthroscopic RCR with LHBT-based SCR, with either in situ LHBT fixation or rerouted LHBT fixation.
• Clinical outcomes (pain, function, range of motion) and radiologic parameters were assessed at 2-year follow-up.

Main Results:

• Significant improvements were observed in Visual Analog Scale (pain) and American Shoulder and Elbow Surgeons scores (function) (P < .001).
• Range of motion significantly improved in forward elevation, abduction, and external rotation.
• Acromiohumeral distance increased, and no progression in Hamada grade was noted, indicating structural integrity.

Conclusions:

• Arthroscopic RCR augmented with LHBT-based SCR provides significant clinical benefits at 2-year follow-up for patients with reparable rotator cuff tears.
• Both in situ and rerouted LHBT fixation techniques for SCR demonstrated comparable clinical and structural outcomes.
• This technique represents a viable option for enhancing rotator cuff repair outcomes.