Groothoff Jonathan D, Mason Thomas W, Fiegen Anthony P, van der List Jelle P, Waterman Brian R
Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Department of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA.
Video J Sports Med. 2025 May 15;5(3):26350254241299461. doi: 10.1177/26350254241299461. eCollection 2025 May-Jun.
Superior capsular reconstruction (SCR) is an effective treatment option for rotator cuff injury. A variety of techniques and grafts can be used, and no clear method of graft fixation has been established.
SCR is indicated for the treatment of irreparable rotator cuff tears refractory to conservative measures, as was observed in this 58-year-old male patient. This procedure reduces superior translation of the humeral head and strengthens the superior capsule of the shoulder.
The patient was positioned in the beach-chair position. Three knotless anchors were placed onto the superior glenoid neck. Anchors were placed into the greater tuberosity adjacent to the articular margin to serve as medial row anchors for final double-row fixation. A dermal allograft was then shuttled into the subacromial space and secured to the glenoid neck. After completion of the SCR, margin convergence-style repair was performed to pull the biceps tendon and infraspinatus tendon over the top of the allograft for additional support.
Complication rates following SCR vary. The most common complication is graft retear, which typically occurs at the medial anchor. Thus, many surgeons prefer a double-row technique for fixation. Graft augmentation to strengthen the overall construct reduces this risk. Dermal allografts less than 3 mm thick are associated with greater failure rates. At 6 months postoperatively, this patient reported 0 out of 10 pain, possessed full range of motion, and continued to gain strength through an at-home physical therapy program.
DISCUSSION/CONCLUSION: Knotless double-row dermal allograft SCR with additional incorporation of the infraspinatus and biceps tendons is a viable option for patients experiencing rotator cuff injuries unresponsive to conservative management. Literature indicates that patient outcomes following this procedure are positive, with high patient satisfaction rates and improved anatomic and functional scores.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
肩胛上盂重建术（SCR）是治疗肩袖损伤的一种有效方法。可采用多种技术和移植物，目前尚未确立明确的移植物固定方法。
SCR适用于治疗经保守治疗无效的不可修复性肩袖撕裂，本58岁男性患者即如此。该手术可减少肱骨头向上移位，并加强肩关节上盂。
患者取沙滩椅位。在肩胛盂上缘置入3枚无结锚钉。在靠近关节边缘的大结节处置入锚钉，作为最终双排固定的内侧排锚钉。然后将同种异体真皮移植物送入肩峰下间隙并固定于肩胛盂上缘。完成SCR后，进行边缘汇聚式修复，将肱二头肌肌腱和冈下肌腱拉至移植物上方以提供额外支撑。
SCR后的并发症发生率各不相同。最常见的并发症是移植物再次撕裂，通常发生在内侧锚钉处。因此，许多外科医生更喜欢采用双排技术进行固定。增强移植物以加强整体结构可降低此风险。厚度小于3 mm的同种异体真皮移植物失败率更高。术后6个月，该患者报告疼痛评分为0（满分10分），活动范围正常，并通过家庭物理治疗计划持续增强力量。
讨论/结论：对于保守治疗无效的肩袖损伤患者，采用无结双排同种异体真皮移植物SCR并额外纳入冈下肌腱和肱二头肌肌腱是一种可行的选择。文献表明，该手术后患者预后良好，患者满意度高，解剖和功能评分改善。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可识别，作者已随本投稿发表包含患者的豁免声明或其他书面批准形式。
