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Comparison of clinical outcome between superior capsule reconstruction and partial repair in irreparable massive rotator cuff tear

35 Background: Rotator cuff disease is the most common cause of chronic shoulder pain in adults. In some cases, massive rotator cuff tear is irreparable. Various surgical techniques have been introduced for irreparable rotator cuff tear; however, no definitive technique has been established yet. To address this concern, we comparatively analyzed superior capsule reconstruction and partial repair to assess the treatment effects of superior capsule reconstruction. Methods: A total of 26 patients were assessed between January 2013 and November 2014. Superior capsule reconstruction was performed in 15 patients and partial repair in 11 patients. The patients were classified into two groups to measure and compare the range of motion (ROM), visual analogue scale (VAS) score, subjective satisfaction (very satisfied, satisfied, rather the same, and dissatisfied), and radiological acromiohumeral distance (AHD) before and after surgery. Results: The ROM of the shoulder joint was better in anterior elevation in the superior capsule reconstruction group than in the partial repair group at the final follow-up (active forward flexion, 132° vs. 70°; P < 0.05). The former group also had better VAS scores (3.4 ± 0.7 vs. 5.6 ± 0.8; P < 0.05). In terms of the patient’s subjective satisfaction, the proportion of “satisfied” and above was higher in the superior capsule reconstruction group (53.3% vs. 27.3%). The radiologically measured AHDs were 5.98, 9.12, and 7.62 mm at presurgery, postsurgery, and final follow-up, respectively, in the superior capsule reconstruction group. In the partial repair group, the AHDs were 6.06, 7.26, and 4.94 mm, respectively. Conclusion: Superior capsule reconstruction can be considered a useful surgical technique for patients with irreparable massive rotator cuff tear with no arthritis.