Superior Capsular Reconstruction versus Bridging Graft: A Prospective RCT

Description

In this presentation by Tan Thangarajah, a Shoulder and Elbow fellow working with Dr. Ian Lo, the focus is on a randomized controlled trial comparing two surgical strategies for addressing massive irreparable rotator cuff tears: superior capsular reconstruction (SCR) and interpositional bridging grafting. The introduction highlights the challenges in treating massive cuff tears and discusses the varied success of existing surgical options.



The trial is designed as a double-blind, prospective study using human dermal allografts, with ethical approval and proper randomization processes in place. The methodology included standardized rehabilitation protocols and multiple follow-up points to assess functional outcomes, utilizing established scoring systems like the American Shoulder and Elbow Surgeons score and the Western Ontario Rotator Cuff index.



Results indicate that while patients in the SCR group showed greater motion at three months, by two years there were no significant differences in functional outcomes or acromio-humeral intervals between the two techniques. Importantly, around 70% of grafts succeeded in healing, with overall better results associated with intact grafts. However, the study's limitations, notably short follow-up time, necessitate further research to explore how patient selection and graft types may impact long-term outcomes. Thangarajah concludes by acknowledging the collaborative efforts of the Calgary team in this significant research endeavor.

DOI: 10.1302/3114-210725

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