Background: Arthroscopic superior capsule reconstruction (ASCR) with combined fascia lata autograft and synthetic scaffold patch graft has been reported to improve graft healing and treat irreparable rotator cuff tears (RCTs). Information about the surgical outcomes of using different synthetic scaffold materials is limited. Purpose: To compare the clinical outcomes of the ASCR technique using LARS ligament with polyethylene terephthalate (PET) material versus polypropylene (PP) mesh scaffold augmentation to treat irreparable RCTs. Study Design: Case series; Level of evidence, 4. Methods: The data of 92 patients with irreparable RCTs who underwent ASCR between 2016 and 2022 were retrospectively evaluated. Among them, 82 of 92 patients who met the inclusion and exclusion criteria were available for follow-up. Fascia lata autografts augmented with LARS ligament (LARS with PET; Corin Group) were used in 43 patients (LARS group), and fascia lata autografts with PP mesh augmentation were used in 39 patients (mesh group). Clinical outcomes were evaluated preoperatively and at a final follow-up by a visual analog scale for pain score and range of motion along with the American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and Constant-Murley score (CMS). Radiological outcomes were assessed according to the rotator cuff arthropathy and acromiohumeral distance stages. Graft integrity and muscle fatty infiltration were evaluated by magnetic resonance imaging. Results: Both groups showed significant improvement in clinical and radiological outcomes at the final follow-up. The LARS group showed significantly better outcomes in mean ASES score (92.6 ± 8.0 vs 77.8 ± 21.3; P < .001), UCLA score (31.5 ± 3.9 vs 24.4 ± 7.5; P < .001), and CMS (86.6 ± 7.2 vs 67.9 ± 18.9; P < .001) compared with the mesh group. The mean active elevation was significantly higher in the LARS group (161.4 ± 19.7) than in the mesh group (124.2 ± 31.3) ( P < .001). The graft healing rate was also significantly higher in the LARS group (91%) than in the mesh group (72%) ( P = .027), and acromiohumeral distance was significantly greater in the LARS group (7.0 ± 1.5 mm) than in the mesh group (6.3 ± 1.5 mm) at the final follow-up ( P = .036). Subgroup analysis revealed that patients with intact grafts demonstrated a more substantial improvement in functional outcomes and active elevation. Conclusion: Compared with combining ASCR with a synthetic PP mesh scaffold graft, augmenting autogenous fascia lata ASCR with a synthetic LARS ligament scaffold graft achieved better functional outcomes and graft healing rate.

中文翻译：

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关节镜下上囊重建联合阔筋膜自体移植物增强 LARS 韧带或聚丙烯网合成支架补片移植物：治疗不可修复的肩袖撕裂的技术比较与至少 2 年随访

背景： 据报道，关节镜下上囊重建术联合阔筋膜自体移植物和合成支架补片移植物可改善移植物愈合并治疗不可修复的肩袖撕裂 （RCT）。关于使用不同合成支架材料的手术结果的信息有限。目的：比较使用聚对苯二甲酸乙二醇酯 （PET） 材料的 LARS 韧带与聚丙烯 （PP） 网状支架增强治疗不可修复的 RCT 的 ASCR 技术的临床结果。研究设计：病例系列;证据水平，4.方法： 回顾性评价 2016 和 2022 年接受 ASCR 的 92 例无法修复的 RCT 患者的数据。其中，符合纳入和排除标准的 92 例患者中有 82 例可进行随访。用 LARS 韧带增强的阔筋膜自体移植物（LARS with PET;Corin 组）用于 43 例患者 （LARS 组），39 例患者 （网片组） 使用带有 PP 网片增强的阔筋膜自体移植物。术前和最终随访时通过疼痛评分和运动范围的视觉模拟量表以及美国肩肘外科医生 （ASES） 评分、加州大学洛杉矶分校 （UCLA） 评分和 Constant-Murley 评分 （CMS） 评估临床结果。根据肩袖关节病和肩肱关节距离分期评估放射学结局。通过磁共振成像评估移植物完整性和肌肉脂肪浸润。结果： 两组在最终随访时均显示临床和放射学结局有显著改善。 LARS 组的平均 ASES 评分 （92.6 ± 8.0 vs 77.8 ± 21.3;P < .001），加州大学洛杉矶分校评分 （31.5 ± 3.9 vs 24.4 ± 7.5;P < .001） 和 CMS （86.6 ± 7.2 对 67.9 ± 18.9;P < .001） 与网格组相比。LARS 组的平均活动升高 （161.4 ± 19.7） 显著高于网片组 （124.2 ± 31.3） （P < .001）。LARS 组的移植物愈合率 （91%） 也显著高于网片组 （72%） （P = .027），并且 LARS 组 （7.0 ± 1.5 mm） 的肩肱距离显著大于网片组 （6.3 ± 1.5 mm） 在最终随访时 （P = .036）。亚组分析显示，完整移植物的患者在功能结果和主动升高方面表现出更显着的改善。结论： 与联合 ASCR 与合成 PP 网眼支架移植物相比，用合成 LARS 韧带支架移植物增强自体阔筋膜 ASCR 取得了更好的功能结局和移植物愈合率。