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Superior capsular reconstruction using the long head of the biceps to treat massive rotator cuff tears improves patients shoulder pain, mobility and function

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Arthroscopic superior capsule reconstruction (SCR) with the long head of the biceps (LHBT) was performed to restore structural stability, force couple balance, and shoulder joint function. This study aimed to evaluate the functional outcomes of SCR using the LHBT over at least 24 months of follow-up.

Method

This retrospective study included 89 patients with massive rotator cuff tears who underwent SCR using the LHBT, met the inclusion criteria and underwent follow up for at least 24 months. The preoperative and postoperative shoulder range of motion (forward flexion, external rotation, and abduction), acromiohumeral interval (AHI), visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score and Constant–Murley score were obtained, and the tear size, and Goutallier and Hamada grades were also investigated.

Results

Compared with those measured preoperatively, the range of motion, AHI, and VAS, Constant–Murley, and ASES scores were significantly improved immediately postoperatively (P < 0.001) and at the 6-month, 12-month, and final follow-ups (P < 0.001). At the last follow-up, the postoperative ASES score and Constant-Murley score increased from 42.8 ± 7.6 to 87.4 ± 6.1, and 42.3 ± 8.9 to 84.9 ± 10.7, respectively; with improvements of 51 ± 21.7 in forward flexion, 21.0 ± 8.1 in external rotation, and 58.5 ± 22.5 in abduction. The AHI increased 2.1 ± 0.8 mm and the VAS score significantly changed from 6.0 (5.0, 7.0) to 1.0 (0.0, 1.0), at the final follow-up. Eleven of the 89 patients experienced retears, and one patient needed reoperation.

Conclusion

In this study with at least 24-months of follow-up, SCR using the LHBT for massive rotator cuff tears could effectively relieve shoulder pain, restore shoulder function and increase shoulder mobility to some extent.

Level of evidence

IV.

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Funding

Supported by National Nature Science Foundation of China (Grant No. 81874125 and 82072966); Clinical Research Plan of SHDC (SHDC2022CRD031); Shanghai Health System Excellent Discipline Leader Training Program; Shanghai Health System Discipline Leader Training Program 2022XD008; Guidance Program of Scientific and Technological Innovation of Bengbu City (Grant No. 20210301).

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Authors and Affiliations

  1. Department of Orthopedics, School of Medicine, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, 200072, People’s Republic of China

    Qiuming Gao, Yue Qiao, Yonghao Guan, Yiwei Zhang, Tianyang Xu, Zhengwei Duan, Lin Fan, Zihua Li & Guodong Li

  2. Department of Orthopedics, Shanghai Jiangqiao Hospital, Jiading Branch of Shanghai General Hospital, Shanghai, 201803, China

    Jian Sun

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  1. Qiuming Gao
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  2. Yue Qiao
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  3. Yonghao Guan
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  4. Yiwei Zhang
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  5. Tianyang Xu
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  7. Lin Fan
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  8. Zihua Li
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  9. Guodong Li
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Correspondence to Zihua Li, Guodong Li or Jian Sun.

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This study received ethical approval from the Ethics Board of Shanghai Tenth People’s Hospital of Tongji University (SHSY-IEC-5.0/22K113/P01).

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Gao, Q., Qiao, Y., Guan, Y. et al. Superior capsular reconstruction using the long head of the biceps to treat massive rotator cuff tears improves patients shoulder pain, mobility and function. Knee Surg Sports Traumatol Arthrosc 31, 4559–4565 (2023). https://doi.org/10.1007/s00167-023-07489-7

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