The Nearest Clinical and Structural Results of Arthroscopic Reconstruction of the Upper Capsule in Patients with Cuff Tear Arthropathy after a Massive Rotator Cuff Tear

Abstract

The purpose of the study was to evaluate the nearest clinical, functional and structural (according to MRI) results of arthroscopic reconstruction of the shoulder upper capsule using an acellular dermal collagen matrix and auto-tissue of the ileotibial band in the patients with shoulder arthropathy after a massive rotator cuff tear. Material and Methods. The study included 30 patients with stage I–IV shoulder arthropathy according to K. Hamada classification. All of them were undergone the arthroscopic reconstruction of the upper part of the shoulder capsule in 2017–2018. The orthopedic procedures were performed by the same surgical team using an acellular dermal collagen matrix as a biological material (group 1) and auto-tissue of the iliotibial band (group 2). Results. The proportion of the patients with good — 8 (26.7%), satisfactory — 14 (46.6%) and poor — 8 (26.7%) surgical outcomes was determined according to the ASES functional assessment scales. Transplant ruptures were recorded in one (3.3%) patient in the group with an acellular dermal collagen matrix and in two (6.6%) patients in the group with the iliotibial autograft. Conclusion. Arthroscopic reconstruction of the upper part of the shoulder capsule is a promising method for the surgical treatment of physically active working age patients with shoulder arthropathy after massive rotator cuff tear. The main goals are restoration of the shoulder vertical stability, centered position of the humeral head towards the glenoid, and improvement of the shoulder biomechanics as a whole.

Keywords

• massive rotator cuff tear
• shoulder arthroplasty
• arthroscopic reconstruction
• upper shoulder capsule
• shoulder arthropathy