Superior capsule reconstruction versus Reverse shoulder arthroplasty in massive rotator cuff tears: A comparative study

Introduction: Superior capsule reconstruction (SCR) was developed in Japan in 2010 as a surgical treatment strategy for massive rotator cuff tears, This study was aimed at performing a comparative analysis of the postoperative results for SCR versus reverse shoulder arthroplasty (RSA), two surgical approaches currently used to treat massive rotator cuff tears. Materials: and Methods: Patients who underwent surgeries from 2014 to 2018 and were followed up for at least 2 years were included in the study. Subsequently, the cases of Hamada classifications 1–3 were retrospectively targeted. SCR comprised 38 patients (mean age 71.4 years) and RSA comprised 24 patients (mean age 78.9 years). The Japanese Orthopaedic Association (JOA) score, University of California at Los Angeles (UCLA) score, active elevation angle, and downward external rotation and internal rotation angles before and after the surgery were evaluated and compared between the groups. Results: : In postoperative group comparison (observed value), SCR significantly improved from RSA in terms of JOA score (p = 0.0060), UCLA score (p = 0.0042), elevation angle (p = 0.0070), downward external rotation (p < 0.001), and internal rotation (p < 0.001). In terms of postoperative comparison between groups (amount of change), RSA was superior in terms of JOA score (p = 0.0128) and UCLA score (p = 0.0055) and SCR showed improvement in terms of downward external rotation (p < 0.001) and internal rotation (p = 0.0016).　 Conclusions: : The results of treatment of massive rotator cuff tears in patients with Hamada's classification 1–3 were good for both techniques. In the postoperative comparison between the groups, downward external rotation and internal rotation showed a significant improvement in SCR in both the observed values and the amount of change.