Evaluating the Role of Graft Integrity on Outcomes: Clinical and Imaging Results Following Superior Capsular Reconstruction

Abstract

Abstract Background Superior capsular reconstruction (SCR) addresses massive, irreparable rotator cuff tears in young patients. The purpose of this study was to retrospectively evaluate clinical outcomes and graft integrity in patients following SCR. Methods Thirty-four consecutive patients undergoing SCR by two surgeons with minimum two-year follow-up were identified. Functional outcomes were obtained, including simple shoulder test (SST), American Shoulder and Elbow Surgeons scores (ASES), visual analog score (VAS), and single assessment numeric evaluation (SANE). Graft integrity was evaluated on MRI. Results 35 shoulders in 34 patients were identified. Four patients underwent subsequent surgery. The mean preoperative scores were SST 21.6 ± 17.6, ASES 28.3 ± 10.1, SANE 50.6 ± 22.1, and VAS 6.6 ± 1.7. The mean postoperative outcomes were SST 79.1 ± 19.6, ASES 79.9 ± 17.4, SANE 74.3 ± 18.7, and VAS 1.5 ± 2.2. There was statistically significant improvement in SST, ASES, and VAS following SCR. MRI imaging revealed graft failure in 62% (n=13 of 21) of shoulders. Radiographic evidence of graft healing did not have any effect on SST, ASES, SANE, or VAS scores. Conclusion Given the high rate of graft failure without a significant difference in clinical outcomes, graft healing after SCR might not be an independent predictor of success. The improved clinical improvement in patients undergoing SCR may be due to other known beneficial aspects of the procedure, including partial rotator cuff repair, debridement, and biceps management. Level of Evidence Level III; Retrospective Cohort Comparison; Treatment Study