Clinical effectiveness of superior capsular reconstruction using Teflon felt graft in the elderly for pain relief: a comparison using tensor fascia lata graft

Abstract

Background: The graft material generally used in superior capsular reconstruction (SCR) may be a human dermal allograft or an autologous tensor fascia lata (TFL) graft. According to a previous biomechanical study, a dermal graft (3 mm) was found to be insufficient and a thicker and stiffer graft was required. However, graft-site mobility should be considered when harvesting TFL, especially in the elderly. We have used Teflon felt as a graft material for SCR in the elderly for pain relief. This study aimed to compare the pain-relieving effects and clinical outcomes between Teflon felt and TFL graft. Methods: This study included 39 patients (Teflon felt group: 19 patients, TFL group: 20 patients) who underwent SCR with a minimum of 2-year follow-up. Patients with painful irreparable rotator cuff tears but with shoulder elevation (abduction or flexion) of at least 130° were included in the study. Shoulder range of motion, acromiohumeral distance, and the numerical rating scale were evaluated preoperatively and 2 years postoperatively. Results: There were no significant differences between the Teflon felt and TFL groups in terms of shoulder elevation (151 ± 33° vs. 164 ± 15°, P = .57), acromiohumeral distance (8.3 ± 2.2 mm vs. 7.5 ± 2.5 mm, P = .14), and numerical rating scale (1.0 ± 1.2 vs. 0.9 ± 0.8, P = .93). Conclusion: SCR with Teflon graft provided pain relief equivalent to TFL graft. It may be an effective treatment option in elderly patients for irreparable rotator cuff tears with respect to pain relief.

Keywords

• Superior capsular reconstruction
• Teflon
• PTFE
• Partial repair
• Spacer
• Dermal graft