Work

Comparison of clinical outcomes of superior capsular reconstruction and reverse shoulder arthroplasty for irreparable rotator cuff tears in patients aged 65 and older: A propensity score-matched study

Year: 2025

Type: article

Abstract: Background/objective: In young patients with massive irreparable rotator cuff tears (MRCTs), superior capsular reconstruction (SCR) is a viable surgical treatment option, whereas SCR and reverse shoulder arthroplasty (RSA) are reliable treatments for irreparable MRCTs in patients aged >65 years. This study aimed to compare the outcomes of arthroscopic SCR and RSA in patients with MRCTs without arthritis aged ≥65. Methods: This retrospective comparative study included 202 patients ≥65 years old with irreparable MRCTs who had undergone either SCR using a 3-4 mm single-layer human acellular dermal matrix or RSA between January 2017 and December 2021. All patients underwent at least 2 years of postoperative follow-up. Propensity score matching was performed based on age, sex, dominant-arm involvement, follow-up duration, body mass index, pseudoparalysis, bone mineral density, global fatty degeneration index, and rotator cuff tear size. A total of 44 matched patients (22 with SCR and 22 with RSA) were included in the analysis. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Single Assessment Numeric Evaluation (SANE), and active range of motion (ROM). Postoperative radiological evaluations were performed to assess healing failure. Results: = 0.01) compared with the RSA group. Healing failure occurred in 6 patients in the SCR group (27.3 %). Conclusion: SCR and RSA resulted in reliable improvements 2 years post-surgery in patients aged >65 years without glenohumeral joint arthritis. However, SCR provided superior outcomes in terms of forward flexion, internal rotation, and functional scores. These results suggest SCR as a more effective treatment option than RSA for irreparable MRCT in this population. Level of evidence: Level III, Retrospective comparative study.

Source: Asia-Pacific Journal of Sports Medicine Arthroscopy Rehabilitation and Technology

DOI: 10.1016/j.asmart.2025.08.001

Authors: Seong Hun Kim, Seung Joo Kim, Jae-Hoo Lee

Institutions: Inje University Ilsan Paik Hospital, National Health Insurance Service Ilsan Hospital

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000