Treatment of massive irreparable rotator cuff tears without arthritis: a comparison of superior capsular reconstruction, partial rotator cuff repair, and reverse total shoulder arthroplasty

To compare outcomes of superior capsular reconstruction (SCR), partial rotator cuff repair (PR), and reverse total shoulder arthroplasty (rTSA) for massive irreparable tear (MIRCT) without arthritis at more than 2 years follow-up. A retrospective analysis prospectively collected data consecutive patients undergoing surgical treatment intraoperatively confirmed MIRCT using SCR, PR, or rTSA. Preoperative postoperative were multivariate performed. Thirty two met inclusion criteria 24 42 rTSA (mean follow-up years: SCR 3.2; PR 4.0; 3.5; P = .02). The older (66.2 years; 57.3; 59.0; .0001) likely to be female (61.9%; 12.5%; 25.0%; < .001). Intraoperative evaluation demonstrated full thickness subscapularis in 37.5% 4.2% 21.4% (P .01). Pseudoparalysis was present 18.8% 0% 14.3% .08). All groups saw improvement strength patient-reported .036). an improved forward elevation range motion (ROM) postoperatively while did not .96). No group experienced rotation ROM > .12). had worse all planes compared .003). There no differences between .16) (American Shoulder Elbow Surgeons .14; visual analog scale .86; single assessment numeric .61). Patients satisfied 81.2% cases, 87.5% 95.3% .33). Three 32 (9.4%) required conversion rTSA, 3 (12.5%) reoperation (2 revision repairs; 1 rTSA). additional complications among (7.1%). 4 nonsurgical the group. One patient deceased. Multivariate independent predictors surgery. An increased acromiohumeral interval distance predictor significantly scores with >80% satisfaction but having a higher complication rate. are viable operations satisfactory results maintained postoperatively.