Cargando…

Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft fo...

Descripción completa

Detalles Bibliográficos
Autores principales: Kitridis, Dimitrios, Yiannakopoulos, Christos, Sinopidis, Chris, Givissis, Panagiotis, Galanis, Nikiforos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000769/
https://www.ncbi.nlm.nih.gov/pubmed/33801508
http://dx.doi.org/10.3390/medicina57030229
_version_ 1783671073935458304
author Kitridis, Dimitrios
Yiannakopoulos, Christos
Sinopidis, Chris
Givissis, Panagiotis
Galanis, Nikiforos
author_facet Kitridis, Dimitrios
Yiannakopoulos, Christos
Sinopidis, Chris
Givissis, Panagiotis
Galanis, Nikiforos
author_sort Kitridis, Dimitrios
collection PubMed
description Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.
format Online
Article
Text
id pubmed-8000769
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-80007692021-03-28 Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes Kitridis, Dimitrios Yiannakopoulos, Christos Sinopidis, Chris Givissis, Panagiotis Galanis, Nikiforos Medicina (Kaunas) Review Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique. MDPI 2021-03-02 /pmc/articles/PMC8000769/ /pubmed/33801508 http://dx.doi.org/10.3390/medicina57030229 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Review
Kitridis, Dimitrios
Yiannakopoulos, Christos
Sinopidis, Chris
Givissis, Panagiotis
Galanis, Nikiforos
Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title_full Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title_fullStr Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title_full_unstemmed Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title_short Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes
title_sort superior capsular reconstruction of the shoulder using the long head of the biceps tendon: a systematic review of surgical techniques and clinical outcomes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000769/
https://www.ncbi.nlm.nih.gov/pubmed/33801508
http://dx.doi.org/10.3390/medicina57030229
work_keys_str_mv AT kitridisdimitrios superiorcapsularreconstructionoftheshoulderusingthelongheadofthebicepstendonasystematicreviewofsurgicaltechniquesandclinicaloutcomes
AT yiannakopouloschristos superiorcapsularreconstructionoftheshoulderusingthelongheadofthebicepstendonasystematicreviewofsurgicaltechniquesandclinicaloutcomes
AT sinopidischris superiorcapsularreconstructionoftheshoulderusingthelongheadofthebicepstendonasystematicreviewofsurgicaltechniquesandclinicaloutcomes
AT givissispanagiotis superiorcapsularreconstructionoftheshoulderusingthelongheadofthebicepstendonasystematicreviewofsurgicaltechniquesandclinicaloutcomes
AT galanisnikiforos superiorcapsularreconstructionoftheshoulderusingthelongheadofthebicepstendonasystematicreviewofsurgicaltechniquesandclinicaloutcomes