Superior Capsular Reconstruction for Massive, Irreparable Rotator Cuff Tears: A Systematic Review of Biomechanical Studies.
PURPOSE: The purpose of this study was to critically review the literature reporting biomechanical outcomes of superior capsular reconstruction (SCR) for the treatment of massive and/or irreparable rotator cuff tears.
METHODS: A systematic review was performed following PRISMA guidelines using PubMed, Medline, and Cochrane databases in August 2020. Cadaveric studies were assessed for glenohumeral translation, subacromial contact pressure, and superior humeral translation comparing SCR to an intact cuff with reference to a torn state control.
RESULTS: A total of 15 studies (142 shoulders) were included for data analysis. SCR demonstrated improvements in superior humeral translation, subacromial contact force, and glenohumeral contact force when biomechanically compared to the massive and/or irreparably torn rotator cuff. No statistically significant differences were found between SCR and the intact rotator cuff in regards to superior humeral translation (standard mean difference (SMD) 2.09 vs 2.50 mm; p=0.54) or subacromial contact force (SMD: 2.85 vs 2.83 mPa; p=0.99). Significant differences were observed between SCR and intact cuff for glenohumeral contact force only, in favor of the intact cuff (SMD: 1.73 vs 5.45N; p=0.03).
CONCLUSIONS: SCR may largely restore static restraints to superior humeral translation with irreparable rotator cuff tears, although active glenohumeral compression is diminished relative to the intact rotator cuff.
Smith, Tyler J; Gowd, Anirudh K; Kunkel, John; Kaplin, Lisa; and Waterman, Brian R, "Superior Capsular Reconstruction for Massive, Irreparable Rotator Cuff Tears: A Systematic Review of Biomechanical Studies." (2020). Orthopedic Surgery Resident Research. 40.