Results of arthroscopic superior capsular reconstruction and reverse shoulder arthroplasty in irreparable massive cuff tears: A prospective matched comparison

Objective: Treatment of irreparable massive rotator cuff tears is a challenge today. There are biological and non-biological treatment options. While it has been reported recently that good results are obtained with the superior capsular reconstruction procedure, which is a biological treatment option, good results are also available in the literature with reverse shoulder arthro-plasty. The aim of the study is to compare the clinical and functional outcomes of these two treatment options in patients with irreparable massive rotator cuff tear and early stage arthropa-thy (Hamada 1-2). Patients and Methods: The study was designed as a prospective comparison of matched groups. Between May 2016 and May 2020, 40 patients who underwent SCR or TOA proce-dures with the diagnosis of irreparable massive rotator cuff in our clinic were included in the study. Patients were divided into two groups according to treatment. While clinical evaluation was performed with shoulder range of motion, and Constant score, ASES and VAS were used for functional evaluation. The postoperative gains in the follow-up parameters of the patients were analyzed by comparing them between the groups. Results: The mean ages and follow-up periods of patients in the SCR (n=20) and TOA (n=20) groups were 61,85±7,56 and 71,1±6,42 years; 22,3±8,4 and 32,5±8,11months, respectively. There was a significant difference between the groups in preoperative abduction, Constant score and ASES values (p:0.005, p:0.027, p:0.008) and the values were lower in the TOA group. In the postoperative data, flexion and Constant score values were found to be significantly higher in the SCR group (p:0.007, p:0.043). When the increase rates obtained in the data were evaluat-ed in the study, no significant difference was found between the two groups in all parameters except abduction (p>0.05). The increase in abduction value in the TOA group was found to be significantly higher than in the SCR group (p:0.003). In addition, post-operative data in all pa-rameters in both SCR and TOA groups showed significant changes compared to pre-operatively. While there is a significant decrease in the VAS value, there is a significant increase in all other parameters. Conclusion: As a result of the study, SCR can provide clinical and functional improvement similar to TOA procedure in the treatment of irreparable massive rotator cuff tears with early stage arthropathy and it can be a biological alternative.