Autologous Fascia Lata Combined With Polypropylene Mesh Versus the Long Head of the Biceps Tendon for Superior Capsular Reconstruction: A 2-Year Retrospective Comparative Cohort Study
Dongxu Yan, Yang Tang, Dongjing Fang, Di Wu, Yao Zhang, Qichun ZhaoBackground:
Superior capsular reconstruction (SCR) is an effective treatment for massive irreparable rotator cuff tears (MIRCTs). Both the long head of the biceps tendon (LHBT) and autologous fascia lata (FL) augmented with polypropylene (PP) mesh are viable graft options, but direct clinical comparisons are limited.
Purpose:
To compare clinical and radiological outcomes of SCR using LHBT versus FL combined with multilayer PP mesh (FL-PP) at a minimum 2-year follow-up.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
The authors retrospectively reviewed the data of 71 patients with MIRCTs who underwent arthroscopic SCR between October 2020 and April 2023. After applying inclusion and exclusion criteria, 62 patients were included (29 FL-PP, 33 LHBT). Clinical outcomes included visual analog scale (VAS) pain score, Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and range of motion. Radiological outcomes included acromiohumeral distance (AHD) and graft integrity/thickness on magnetic resonance imaging.
Results:
Both groups showed significant improvement in all clinical and radiological parameters at the final follow-up. The FL-PP group had significantly lower VAS scores at 3 months (2.34 ± 0.90 vs 3.06 ± 0.96;
Conclusion:
Both LHBT and FL-PP grafts yielded satisfactory outcomes after SCR. However, the FL-PP composite graft provided statistically significant early pain relief, strength recovery, and graft integrity and is an effective alternative when the LHBT is degenerated or unsuitable.