Abstract
Background
Based on a systematic review, the present work analyses factors associated with the
rerupture rate or non-healing after superior capsular reconstruction with autologous
long biceps tendon in the reconstruction of the rotator cuff of the shoulder.
Materials and Methods
A systematic review of the U.S. National Library of Medicine/National Institutes of
Health (PubMed) database and the Cochrane Library was conducted in September 2021
using the PRISMA checklist. Articles were identified and analysed that contained data
on the rerupture rate after superior capsular reconstruction with autologous long
biceps tendon in reconstruction of the rotator cuff of the shoulder. The aim was to
identify factors associated with rerupture or non-healing. The risk of bias was determined
using the Newcastle-Ottawa scale.
Results
Primarily 86 hits could be generated. Seven articles from 2020 and 2021 met the inclusion
criteria and were further analysed in terms of content. The evidence level was III
to IV. Follow-up was between 12 (minimum) and 24 to 48 months. The risk of bias was
not low. Factors that may be associated with rerupture or non-healing are diabetes
mellitus and high-grade fatty degeneration of the subscapularis, infraspinatus, or
teres minor as preoperative factors. Age, percent footprint coverage, tear size, symptom
duration, number of bundles, acromioplasty performed, and tear configuration were
not significant factors. Gender, degree of fatty degeneration of the supraspinatus
and lesions of the subscapularis tendon were rated differently.
Conclusion
According to the literature, but still currently with short-term observation periods,
superior capsular reconstruction with an autologous long biceps tendon is another
treatment option in the case of massive tears and elderly patients, if there is no
high-grade fatty degeneration of the subscapularis, infraspinatus or teres minor.
Diabetes mellitus has an unfavorable prognosis. Additional acromioplasty has so far
not been associated with better outcomes.
Keywords shoulder - biceps - rerouting - superior capsular reconstruction - rerupture
