Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction
Background: Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group. Purpose/Hypothesis: The purpose of this study was to cor...
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| Veröffentlicht in: | The American journal of sports medicine 2024-10, Vol.52 (12), p.3065-3074 |
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| creator | Mirzayan, Raffy Acevedo, Daniel C. Yao, Janis F. Otarodifard, Karimdad A. Hall, Michael Suh, Brian D. Singh, Anshuman |
| description | Background:
Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.
Purpose/Hypothesis:
The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft. It was hypothesized that the functional outcomes of patients with an intact graft would be equivalent to those with graft tears leaving the tuberosity covered.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent SCR with an acellular dermal allograft at a single institution were included. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score, visual analog scale (VAS) for pain, and postoperative Single Assessment Numeric Evaluation (SANE) scores were recorded. A magnetic resonance imaging scan was performed postoperatively to assess graft integrity.
Results:
A total of 39 patients met inclusion criteria. Mean age of patients was 60.4 ± 8.7 years; mean follow-up was 53.3 ± 25 months (range, 14-98 months). Magnetic resonance imaging performed at a mean of 17.5 months (range, 6-66 months) demonstrated an intact graft in 14 (36%); tear from the glenoid in 11 (28%), from midsubstance in 4 (10%), and from the tuberosity in 8 (21%); and complete graft absence in 2 (5%). Patients were divided into group 1 (intact graft), group 2 (tuberosity covered: tears from glenoid and midsubstance tears), and group 3 (tuberosity bare: tears from the tuberosity and dissolved or absent grafts). In group 1, there was significant improvement in ASES (37.9 to 88.5; P < .001), Oxford (25.2 to 46.2; P < .001), and VAS (6.8 to 0.9; P < .001). In group 2, there was significant improvement in ASES (32.2 to 86.1; P < .001), Oxford (23.4 to 44.2; P < .001), and VAS (7.3 to 1.3; P < .001). In group 3, there was no significant improvement in ASES (40.3 to 45.8; P = .50) or Oxford (33.5 to 31.4; P = .81), but there was a significant reduction in VAS (7.1 to 5.4; P = .03). There was no significant difference between group 1 and 2 in postoperative ASES (88.5 vs 86.1; P = .59), Oxford (46.2 vs 44.2; P = .07), VAS (0.9 vs 1.3, P = .42) and SANE (85.4 vs 83.2; P = .92) scores. However, group 3 had significantly lower ASES (45.8; P < .001), lower Oxford (31.4; P < .001), lower SANE (45.4; P < .001), and higher VAS (5.4; P < .001) scor |
| doi_str_mv | 10.1177/03635465241278358 |
| format | Article |
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Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.
Purpose/Hypothesis:
The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft. It was hypothesized that the functional outcomes of patients with an intact graft would be equivalent to those with graft tears leaving the tuberosity covered.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent SCR with an acellular dermal allograft at a single institution were included. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score, visual analog scale (VAS) for pain, and postoperative Single Assessment Numeric Evaluation (SANE) scores were recorded. A magnetic resonance imaging scan was performed postoperatively to assess graft integrity.
Results:
A total of 39 patients met inclusion criteria. Mean age of patients was 60.4 ± 8.7 years; mean follow-up was 53.3 ± 25 months (range, 14-98 months). Magnetic resonance imaging performed at a mean of 17.5 months (range, 6-66 months) demonstrated an intact graft in 14 (36%); tear from the glenoid in 11 (28%), from midsubstance in 4 (10%), and from the tuberosity in 8 (21%); and complete graft absence in 2 (5%). Patients were divided into group 1 (intact graft), group 2 (tuberosity covered: tears from glenoid and midsubstance tears), and group 3 (tuberosity bare: tears from the tuberosity and dissolved or absent grafts). In group 1, there was significant improvement in ASES (37.9 to 88.5; P < .001), Oxford (25.2 to 46.2; P < .001), and VAS (6.8 to 0.9; P < .001). In group 2, there was significant improvement in ASES (32.2 to 86.1; P < .001), Oxford (23.4 to 44.2; P < .001), and VAS (7.3 to 1.3; P < .001). In group 3, there was no significant improvement in ASES (40.3 to 45.8; P = .50) or Oxford (33.5 to 31.4; P = .81), but there was a significant reduction in VAS (7.1 to 5.4; P = .03). There was no significant difference between group 1 and 2 in postoperative ASES (88.5 vs 86.1; P = .59), Oxford (46.2 vs 44.2; P = .07), VAS (0.9 vs 1.3, P = .42) and SANE (85.4 vs 83.2; P = .92) scores. However, group 3 had significantly lower ASES (45.8; P < .001), lower Oxford (31.4; P < .001), lower SANE (45.4; P < .001), and higher VAS (5.4; P < .001) scores than groups 1 and 2. There were no differences in outcomes based on sex (P = .72), previous surgery (P = .06), preoperative acromiohumeral distance (P = .57), and preoperative Goutallier stage of the supraspinatus (P = .16).
Conclusion:
Patients who underwent SCR with a dermal allograft and developed a graft tear leaving the tuberosity covered had equivalent functional outcomes to those with an intact graft.]]></description><identifier>ISSN: 0363-5465</identifier><identifier>ISSN: 1552-3365</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465241278358</identifier><identifier>PMID: 39432391</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Acellular Dermis ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Plastic Surgery Procedures - methods ; Retrospective Studies ; Rotator Cuff Injuries - surgery ; Shoulder Joint - surgery ; Treatment Outcome</subject><ispartof>The American journal of sports medicine, 2024-10, Vol.52 (12), p.3065-3074</ispartof><rights>2024 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c250t-fc6ef787cdffde8c70135ca7d7e04f7eecfc9fa21c94f69d4fc8cd66597abeda3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465241278358$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465241278358$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39432391$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mirzayan, Raffy</creatorcontrib><creatorcontrib>Acevedo, Daniel C.</creatorcontrib><creatorcontrib>Yao, Janis F.</creatorcontrib><creatorcontrib>Otarodifard, Karimdad A.</creatorcontrib><creatorcontrib>Hall, Michael</creatorcontrib><creatorcontrib>Suh, Brian D.</creatorcontrib><creatorcontrib>Singh, Anshuman</creatorcontrib><title>Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description><![CDATA[Background:
Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.
Purpose/Hypothesis:
The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft. It was hypothesized that the functional outcomes of patients with an intact graft would be equivalent to those with graft tears leaving the tuberosity covered.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent SCR with an acellular dermal allograft at a single institution were included. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score, visual analog scale (VAS) for pain, and postoperative Single Assessment Numeric Evaluation (SANE) scores were recorded. A magnetic resonance imaging scan was performed postoperatively to assess graft integrity.
Results:
A total of 39 patients met inclusion criteria. Mean age of patients was 60.4 ± 8.7 years; mean follow-up was 53.3 ± 25 months (range, 14-98 months). Magnetic resonance imaging performed at a mean of 17.5 months (range, 6-66 months) demonstrated an intact graft in 14 (36%); tear from the glenoid in 11 (28%), from midsubstance in 4 (10%), and from the tuberosity in 8 (21%); and complete graft absence in 2 (5%). Patients were divided into group 1 (intact graft), group 2 (tuberosity covered: tears from glenoid and midsubstance tears), and group 3 (tuberosity bare: tears from the tuberosity and dissolved or absent grafts). In group 1, there was significant improvement in ASES (37.9 to 88.5; P < .001), Oxford (25.2 to 46.2; P < .001), and VAS (6.8 to 0.9; P < .001). In group 2, there was significant improvement in ASES (32.2 to 86.1; P < .001), Oxford (23.4 to 44.2; P < .001), and VAS (7.3 to 1.3; P < .001). In group 3, there was no significant improvement in ASES (40.3 to 45.8; P = .50) or Oxford (33.5 to 31.4; P = .81), but there was a significant reduction in VAS (7.1 to 5.4; P = .03). There was no significant difference between group 1 and 2 in postoperative ASES (88.5 vs 86.1; P = .59), Oxford (46.2 vs 44.2; P = .07), VAS (0.9 vs 1.3, P = .42) and SANE (85.4 vs 83.2; P = .92) scores. However, group 3 had significantly lower ASES (45.8; P < .001), lower Oxford (31.4; P < .001), lower SANE (45.4; P < .001), and higher VAS (5.4; P < .001) scores than groups 1 and 2. There were no differences in outcomes based on sex (P = .72), previous surgery (P = .06), preoperative acromiohumeral distance (P = .57), and preoperative Goutallier stage of the supraspinatus (P = .16).
Conclusion:
Patients who underwent SCR with a dermal allograft and developed a graft tear leaving the tuberosity covered had equivalent functional outcomes to those with an intact graft.]]></description><subject>Acellular Dermis</subject><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Plastic Surgery Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Rotator Cuff Injuries - surgery</subject><subject>Shoulder Joint - surgery</subject><subject>Treatment Outcome</subject><issn>0363-5465</issn><issn>1552-3365</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v1DAQhi0EokvhB3BBlrhwSfFHbMfHatUvaaUiuohj5HXGXVdJvPhjpf4ZfivZZgsSiNMc5plnNPMi9J6SM0qV-ky45KKWgtWUqYaL5gVaUCFYxbkUL9Hi0K8OwAl6k9IDIYQq2bxGJ1zXnHFNF-jnF5M9jDnh7z5v8VU0LuM1mJjwCszej_c4bwGvywZiSD4_4mXYQ4QOX5s94Ds_-N5EfFlGm30YTY9vS7ZhgIRzwOttSDCbzYhvxmxsPu44dxkivis7iD5EvDS7VA6mr2DDmHIsT7636JUzfYJ3x3qKvl1erJfX1er26mZ5vqosEyRXzkpwqlG2c66DxipCubBGdQpI7RSAdVY7w6jVtZO6q51tbCel0MpsoDP8FH2avbsYfhRIuR18stD3ZoRQUssp1VSTWuoJ_fgX-hBKnC6fKcYZk_VE0Zmy09tSBNfuoh9MfGwpaQ_htf-EN818OJrLZoDu98RzWhNwNgPJ3MOftf83_gJAs6Uh</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Mirzayan, Raffy</creator><creator>Acevedo, Daniel C.</creator><creator>Yao, Janis F.</creator><creator>Otarodifard, Karimdad A.</creator><creator>Hall, Michael</creator><creator>Suh, Brian D.</creator><creator>Singh, Anshuman</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>202410</creationdate><title>Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction</title><author>Mirzayan, Raffy ; Acevedo, Daniel C. ; Yao, Janis F. ; Otarodifard, Karimdad A. ; Hall, Michael ; Suh, Brian D. ; Singh, Anshuman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c250t-fc6ef787cdffde8c70135ca7d7e04f7eecfc9fa21c94f69d4fc8cd66597abeda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acellular Dermis</topic><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Plastic Surgery Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Rotator Cuff Injuries - surgery</topic><topic>Shoulder Joint - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mirzayan, Raffy</creatorcontrib><creatorcontrib>Acevedo, Daniel C.</creatorcontrib><creatorcontrib>Yao, Janis F.</creatorcontrib><creatorcontrib>Otarodifard, Karimdad A.</creatorcontrib><creatorcontrib>Hall, Michael</creatorcontrib><creatorcontrib>Suh, Brian D.</creatorcontrib><creatorcontrib>Singh, Anshuman</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mirzayan, Raffy</au><au>Acevedo, Daniel C.</au><au>Yao, Janis F.</au><au>Otarodifard, Karimdad A.</au><au>Hall, Michael</au><au>Suh, Brian D.</au><au>Singh, Anshuman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2024-10</date><risdate>2024</risdate><volume>52</volume><issue>12</issue><spage>3065</spage><epage>3074</epage><pages>3065-3074</pages><issn>0363-5465</issn><issn>1552-3365</issn><eissn>1552-3365</eissn><abstract><![CDATA[Background:
Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.
Purpose/Hypothesis:
The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft. It was hypothesized that the functional outcomes of patients with an intact graft would be equivalent to those with graft tears leaving the tuberosity covered.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent SCR with an acellular dermal allograft at a single institution were included. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score, visual analog scale (VAS) for pain, and postoperative Single Assessment Numeric Evaluation (SANE) scores were recorded. A magnetic resonance imaging scan was performed postoperatively to assess graft integrity.
Results:
A total of 39 patients met inclusion criteria. Mean age of patients was 60.4 ± 8.7 years; mean follow-up was 53.3 ± 25 months (range, 14-98 months). Magnetic resonance imaging performed at a mean of 17.5 months (range, 6-66 months) demonstrated an intact graft in 14 (36%); tear from the glenoid in 11 (28%), from midsubstance in 4 (10%), and from the tuberosity in 8 (21%); and complete graft absence in 2 (5%). Patients were divided into group 1 (intact graft), group 2 (tuberosity covered: tears from glenoid and midsubstance tears), and group 3 (tuberosity bare: tears from the tuberosity and dissolved or absent grafts). In group 1, there was significant improvement in ASES (37.9 to 88.5; P < .001), Oxford (25.2 to 46.2; P < .001), and VAS (6.8 to 0.9; P < .001). In group 2, there was significant improvement in ASES (32.2 to 86.1; P < .001), Oxford (23.4 to 44.2; P < .001), and VAS (7.3 to 1.3; P < .001). In group 3, there was no significant improvement in ASES (40.3 to 45.8; P = .50) or Oxford (33.5 to 31.4; P = .81), but there was a significant reduction in VAS (7.1 to 5.4; P = .03). There was no significant difference between group 1 and 2 in postoperative ASES (88.5 vs 86.1; P = .59), Oxford (46.2 vs 44.2; P = .07), VAS (0.9 vs 1.3, P = .42) and SANE (85.4 vs 83.2; P = .92) scores. However, group 3 had significantly lower ASES (45.8; P < .001), lower Oxford (31.4; P < .001), lower SANE (45.4; P < .001), and higher VAS (5.4; P < .001) scores than groups 1 and 2. There were no differences in outcomes based on sex (P = .72), previous surgery (P = .06), preoperative acromiohumeral distance (P = .57), and preoperative Goutallier stage of the supraspinatus (P = .16).
Conclusion:
Patients who underwent SCR with a dermal allograft and developed a graft tear leaving the tuberosity covered had equivalent functional outcomes to those with an intact graft.]]></abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>39432391</pmid><doi>10.1177/03635465241278358</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2024-10, Vol.52 (12), p.3065-3074 |
| issn | 0363-5465 1552-3365 1552-3365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3119190469 |
| source | SAGE Complete A-Z List; MEDLINE; Alma/SFX Local Collection |
| subjects | Acellular Dermis Aged Female Humans Magnetic Resonance Imaging Male Middle Aged Plastic Surgery Procedures - methods Retrospective Studies Rotator Cuff Injuries - surgery Shoulder Joint - surgery Treatment Outcome |
| title | Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction |
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