Superior Capsule Reconstruction for Irreparable Rotator Cuff Tear with a Porcine Dermal Graft: Preliminary Results
Orthopaedic Department, CHU Bichat, France
Introduction: Currently, no consensus has been achieved regarding treatment of irreparable and massive rotator cuff tears in young subjects. The purpose of this study was to evaluate clinical outcomes and the acromiohumeral interval after superior capsular reconstruction, using a porcine dermal graft.
Methods: In this prospective study, patients that underwent arthroscopic superior capsule reconstruction were included. All grafts used a dermal matrix of porcine origin. Inclusion criteria were symptomatic massive, irreparable supraspinatus tendon tear, shoulder osteoarthritis staged
Results: Among the 15 patients enrolled, the mean age was 57 ± 6.1 years. The mean follow-up period was 26 ± 6 months. Mean Constant score improved significantly from a preoperative score of 32 ± 7 to 62 ± 13 (p = 0.0198). Mean forward flexion moved from 80 ± 15 ° to 105 ± 40° at baseline (p = 0.0488). Mean muscle strength increased from 3.9 kg ± 4.9 preoperatively to 8.0 kg ± 2.6 at last follow-up (p>0,05). Mean ASES Score increased from 38 ± 15.4 to 71,2 ± 19,0 at the last follow-up (p = 0.002).
The visual analogue scale score for pain during motion had decreased to 3.5 ± 3 from a preoperative mean of 6.3 ± 0.9, p=0.0003. The acromiohumeral height increased from 6.5mm ± 1.3 to 8.0mm ± 2.4, p=0.039.
At the last follow up, major complications included 4 revisions; all were a conversion to reversed shoulder prostheses.
Discussion and Conclusion: In this preliminary study, superior capsule reconstruction for irreparable rotator cuff tear with a porcine dermal graft showed significant improvements in shoulder outcomes. Despite a high rate of revisions, superior capsule reconstruction with such porcine graft may be an effective and safe treatment to re-centring the humeral head with respect to the glenoid on this demanding population.
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