Superior capusular reconstruction (SCR) is an established procedure in the treatment of irreparable rotator cuff (RC) tears. There is still controversy regarding the best transplant for this operation. The aim of this study is to demonstrate structural and clinical results one year after SCR using autologous long head of the biceps (LHB) graft. (LHB-SCR). The hypothesis is that there is a significant improvement in clinical score results one year after the intervention with a radiographically intact graft.
Between 2019-2020 23 patients have been treated with arthroscopic LBS-SCR due to irrepairable postero-superior RC tears. The origin of the LHB was preserved and the tendon was armed with to suture loops and fixed at the footprint between the supra- and infraspinatus insertion side using two knotless anchors. The posterior part of the RC was also fixed to the foot print and side to side to the LHB. Preoperatively and at follow up ROM, subjective shoulder value (SSV) and power were analyzed and the Constant-Score (CS), DASH, WORC, ADLEIR, Oxford-Shoulder-Score (OSS) were evaluated. Integrity of the reconstructin was evaluated by MRI one year postoperatively.
Mean follow-up was 14,9 ± 3,9 months. The mean age was 62,8 ± 8,1 years (47-78 years). Active Flexion improved from 110,0° ± 53,9 to 153,9° ± 26,0 (p=0,002) and active Abduction from106,1° ± 54,3 to 146,1° ± 35,0 (p=0,008) at follow up. External rotation improved from 39,4° ± 16,5 to 40,7° ± 15 (p=n.s.). The score results at final follow up were: absolut CS: 66,0 ± 11,7; DASH: 22,6 ± 18,8; WORC: 70,8% ± 22,5; ADLEIR: 32,7 ± 3,8 and OSS: 22,5 ± 8,5. The SSV significantly improved from 42,4% ± 18,1 to 73,9% ± 14,0 (p<0.0001). Postoperative MRI showed an intact LHB graft in 84% of all cases.
LBS-SCR shows promising clinical and structural results at 1 year follow up. Longer Follow-Up data and the comparison to alternative transplants would be necessary to further evaluate the value of this treatment option.