Cheng You-Hung, Chen Poyu, Chen Chung-Yu, Yang Cheng-Pang, Hsu Chen-Heng, Chen Alvin Chao-Yu, Chiu Joe Chih-Hao
Department of Orthopedic Surgery, New Taipei Municipal Tu-Cheng Hospital, Chang Gung Memorial Hospital; Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial Hospital.
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University; Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital.
J Vis Exp. 2025 Jun 6(220). doi: 10.3791/68064.
This study explores the efficacy of superior capsule reconstruction (SCR) using fascia lata autograft for treating irreparable rotator cuff tears. Based on our experience and existing literature, SCR has demonstrated promising outcomes, offering improved shoulder stability, reduced pain, and prevention of humeral head migration. Patients undergoing SCR with fascia lata autograft achieved near-normal shoulder range of motion postoperatively, with maintained acromio-humeral distance observed in radiographic follow-ups. Various graft modifications, including the use of dermal grafts and the long head of the biceps tendon, have been explored. Yet, studies indicate the superior thickness and tensile strength of fascia lata autograft supports more durable outcomes. The SCR protocol detailed in this study includes meticulous graft harvesting, arthroscopic examination, and precise graft placement with suture anchors to ensure stability. Postoperative care involves immobilization followed by gradual rehabilitation, promoting effective healing and functional recovery. This approach highlights SCR's potential as a valuable treatment for active patients with irreparable rotator cuff tears.
本研究探讨使用自体阔筋膜进行上盂唇重建(SCR)治疗不可修复的肩袖撕裂的疗效。根据我们的经验和现有文献,SCR已显示出有前景的结果,可改善肩部稳定性、减轻疼痛并防止肱骨头移位。接受自体阔筋膜SCR的患者术后实现了接近正常的肩部活动范围,影像学随访观察到肩峰下间隙保持稳定。已探索了各种移植物改良方法,包括使用真皮移植物和肱二头肌长头肌腱。然而,研究表明自体阔筋膜移植物的厚度和拉伸强度更优,可支持更持久的疗效。本研究中详细描述的SCR方案包括细致的移植物获取、关节镜检查以及使用缝合锚钉精确放置移植物以确保稳定性。术后护理包括固定,随后逐步进行康复,促进有效愈合和功能恢复。这种方法凸显了SCR作为治疗不可修复肩袖撕裂的活跃患者的一种有价值治疗方法的潜力。