The study
A new paper in the Journal of Shoulder and Elbow Surgery examines combined cuff repair and superior capsular reconstruction (CRACR) for massive rotator cuff tears and retears. The cohort comprised over 50 patients, followed for a minimum of two years, with both clinical and radiological assessment.
The problem it addresses
Massive rotator cuff tears, and tears that have already failed one repair, carry a high risk of failing again after further surgery. Published series report retear rates after repair of large and massive tears that are substantially higher than for smaller tears. That is the reason for interest in reinforcing a repair rather than simply repeating it.
The CRACR approach repairs the cuff tendon and additionally reconstructs the superior capsule with a graft, so that the repair is not relying on compromised tendon alone.
What was reported
The published study reports significant improvements in pain, function and shoulder stability at a minimum of two years, with repair integrity on imaging described as promising. The full figures are in the paper. Individual results vary.
The approach is presented as a joint-preserving option for shoulders that would otherwise be heading towards a reverse total shoulder replacement. It should be noted that the study did not directly compare the two, so it establishes what this approach achieves rather than that it is better than the alternatives.
Collaborators
Freek Hollman, Mohammad Jomaa, Nagmani Singh, Brandon Ziegenfuss, Praveen Vijaysegaran, Kristine Italia, Sarah Whitehouse, Ridzwan Mohamed Namazie and Ashish Gupta, together with QUASR and partnering institutions.
With thanks to our patients
Thank you to the patients who took part. A study with a minimum two-year follow-up depends on people returning for assessment long after their own treatment is finished.
Read it
The paper is available via this link: read the study.
Related information
See our rotator cuff tear and rotator cuff repair pages, and our posts on superior capsular reconstruction and rotator cuff repair and rotator cuff repairs and retear.