Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft

The treatment of massive and irreparable rotator cuff tears remains a challenge for shoulder surgeons. When treating patients with chronic rotator cuff tears, especially those with severe fatty degeneration, severe tendon retraction, or muscle atrophy, the risk of re-tear and persistent severe pain...

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Main Authors: Jeong Woo Kim, M.D., Ph.D., Dae Jin Nam, M.D.
Format: Article
Language:English
Published: Elsevier 2020-02-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628719302312
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author Jeong Woo Kim, M.D., Ph.D.
Dae Jin Nam, M.D.
author_facet Jeong Woo Kim, M.D., Ph.D.
Dae Jin Nam, M.D.
author_sort Jeong Woo Kim, M.D., Ph.D.
collection DOAJ
description The treatment of massive and irreparable rotator cuff tears remains a challenge for shoulder surgeons. When treating patients with chronic rotator cuff tears, especially those with severe fatty degeneration, severe tendon retraction, or muscle atrophy, the risk of re-tear and persistent severe pain persists. Therefore, surgeons can choose from numerous options. Superior capsular reconstruction (SCR) was introduced as a technique to maintain the stability of the upper shoulder and stabilize the muscles without repairing the supraspinatus and infraspinatus. Various autograft and allograft techniques have been developed. SCR performed using an autograft has the disadvantage of requiring harvesting the tensor fascia lata. Although allografts reduce harvest time, they also increase donor-site morbidity and the time required for healing. To solve the healing problem, we have introduced an SCR technique through grafting with the Achilles tendon–bone. Although this is an unproven technique for patients with chronic irreparable rotator cuff tears, our short-term outcomes seem promising. Further studies and follow-ups are needed to determine the success of this technique.
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spelling doaj.art-16b075dff8d6440d9a5d730c70ac02012022-12-21T20:01:38ZengElsevierArthroscopy Techniques2212-62872020-02-0192e275e281Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone AllograftJeong Woo Kim, M.D., Ph.D.0Dae Jin Nam, M.D.1Address correspondence to Jeong Woo Kim, Department of Orthopedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.; Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, KoreaDepartment of Orthopedic Surgery, Wonkwang University Hospital, Iksan, KoreaThe treatment of massive and irreparable rotator cuff tears remains a challenge for shoulder surgeons. When treating patients with chronic rotator cuff tears, especially those with severe fatty degeneration, severe tendon retraction, or muscle atrophy, the risk of re-tear and persistent severe pain persists. Therefore, surgeons can choose from numerous options. Superior capsular reconstruction (SCR) was introduced as a technique to maintain the stability of the upper shoulder and stabilize the muscles without repairing the supraspinatus and infraspinatus. Various autograft and allograft techniques have been developed. SCR performed using an autograft has the disadvantage of requiring harvesting the tensor fascia lata. Although allografts reduce harvest time, they also increase donor-site morbidity and the time required for healing. To solve the healing problem, we have introduced an SCR technique through grafting with the Achilles tendon–bone. Although this is an unproven technique for patients with chronic irreparable rotator cuff tears, our short-term outcomes seem promising. Further studies and follow-ups are needed to determine the success of this technique.http://www.sciencedirect.com/science/article/pii/S2212628719302312
spellingShingle Jeong Woo Kim, M.D., Ph.D.
Dae Jin Nam, M.D.
Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
Arthroscopy Techniques
title Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
title_full Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
title_fullStr Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
title_full_unstemmed Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
title_short Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft
title_sort arthroscopic superior capsular reconstruction by the mini open modified keyhole technique using an achilles tendon bone allograft
url http://www.sciencedirect.com/science/article/pii/S2212628719302312
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