부산대학교 도서관

Abstract: Massive rotator cuff tears (mRCT) are challenging and superior capsular reconstruction (SCR) with the long head of the biceps tendon (LHBT) has been described as a possible solution. The purpose of this study was to systematically evaluate the literature concerning SCR using LHBT in biomechanical and clinical studies. A systematic review according to the PRISMA statement was designed, including studies from January 2020 until June 2022. Studies were selected according to a two-stage process (two independent observers). Data was extracted reporting general information, biomechanical and clinical outcomes. Five biomechanical and nine clinical studies were included. In the biomechanical studies (n = 42 shoulders), different techniques were used to perform SCR with LHBT. Superior translation was significantly decreased comparing to the tear condition in three out of four studies. Subacromial peak pressure was significantly decreased in one out of three studies. Heterogeneity in testing conditions and outcome assessment limited comparison between studies. In the clinical studies (n = 271), significant improvements in forward flexion comparing to preoperative measurements were found. Functional scores (Visual Analogue Scale [VAS], Constant-Murley [CMS] and American Shoulder and Elbow Score [ASES]) were also significantly improved. Reported complications were mainly stiffness and a 2 to 22% rate of graft failure.Variations in the surgical technique and outcome assessment were major limitations that should be considered. Nevertheless, this review provides clinical and biomechanical data that may guide future research and clinical practice. SCR using the LHBT produces promising biomechanical and clinical results, with a reduction in superior translation and subacromial peak pressure and improved forward flexion, VAS, CMS and ASES.