Complications of Superior Capsule Reconstruction for the treatment of Functionally Irreparable Rotator Cuff Tears (FIRCT): A Systematic Review.

PURPOSE: The purpose of this systematic review is to characterize the complications associated with Superior Capsule Reconstruction (SCR) for the treatment of Functionally Irreparable Rotator Cuff Tears (FIRCTs).

METHODS: This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent reviewers completed a search of PubMed, Embase and Medline databases. Studies were deemed eligible for inclusion if they reported post-operative outcomes of arthroscopic SCR for FIRCTs and considered at least one post-operative complication. Statistical heterogeneity was quantified via the I2 statistic. Due to marked heterogeneity, pooled proportions were not reported. All complications and patient-reported outcomes were described qualitatively.

RESULTS: 14 studies met the inclusion/exclusion criteria. The overall complication rate post SCR ranged from 5.0%-70.0% (I2 = 84.9%). Image verified graft re-tear ranged from 8%-70%, I2 = 79.4%) with higher rates reported when SCR was performed using allograft (19%-70%, I2 76.6%) compared to autograft (8%-29%, I2 = 66.1%). Reoperation (0%-36%, I2 = 73.4%), revision surgeries (0%-21%, I2 = 81.2%), medical complications (0%-5%, I2 = 0.0%) and infections (0%-5%, I2 = 0.0%) were also calculated.

CONCLUSION: SCR carries a distinct complication profile when used for the treatment of FIRCTs. The overall rate of complications ranged from 5.0%-70.0%. The most common complication is graft retear with higher ranges in allografts (19%-70%) compared to autografts (8%-29%). The majority of studies reported at least one reoperation (range: 0-36%), most commonly for revision to reverse shoulder arthroplasty.