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New surgical option for patients with irreparable rotator cuff tears

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Patients with irreparable rotator cuff tears can benefit from a new surgical treatment known as arthroscopic superior capsule reconstruction (SCR), new research shows.

A Japanese study assessing the outcomes for 102 shoulders in 100 patients found restored shoulder function and high rates of return to recreational sport and work.

The findings were presented at the recent annual meeting of the American Orthopaedic Society for Sports Medicine in Toronto, Canada.

“We studied 100 patients who did not improve after conservative treatment approaches, but then were treated with the arthroscopic SCR method our team developed,” explained lead researcher Dr Teruhis Mihata, from Osaka Medical College in Osaka, Japan. “Our research found that this treatment method allowed all 26 patient athletes to return to their previous sports, and 32 patients with heavy workloads to return to their jobs.”

Among the 100 patients studied, 34 had been employed before surgery (21 manual workers, 10 farmers, one butcher, one cook and one athletic trainer) and 26 played sports, most at recreational level (six golf, four table tennis, four swimming, three martial arts, two baseball, two yoga, one tennis, one badminton, one skiing, one mountain-climbing and one ground golf).

The researchers measured shoulder range of motion before surgery, at three, six and 12 months, and yearly after that, and analysed the healing rate and return-to-sports and work rate.

There was no graft tear or re-tear of the repaired rotator cuff tendon during the follow-up period for 95 of the 102 shoulders (93.1%). Three shoulders (2.9%) with severe fatty degeneration of the infraspinatus tendon had a re-tear of the repaired infraspinatus tendon at three months after surgery. Four shoulders (3.9%) suffered a postoperative graft tear by three months (two patients) or one year (two patients) after surgery.

Average clinical outcome scores and shoulder active range of motion after arthroscopic SCR all improved significantly at final follow-up.

All 26 patients who had played sport before their injuries returned fully to their previous sports and 32 returned fully to their previous jobs, while two (one farmer and one manual worker) returned with reduced hours and workloads.

The researchers concluded that arthroscopic superior capsule reconstruction is a viable surgical option for irreparable rotator cuff tears, especially in patients who work and enjoy sport.