Suture tape-based SCR in massive rotator cuff tear repair provides comparable functional outcomes to biceps tendon-based SCR with a lower re-tear rate

Abstract

Purpose: This study aimed to compare postoperative functional outcomes, anatomical restoration and re-tear rates between the long head of the biceps tendon (LHBT) and suture tape (ST)-based superior capsular reconstruction (SCR) in patients undergoing partial repair for massive rotator cuff tears. It was hypothesized that ST reconstruction would achieve lower re-tear rates while providing comparable functional results. Methods: A retrospective cohort of 56 patients treated for massive rotator cuff tears between 2017 and 2022 was analysed. Thirty patients underwent partial repair with LHBT-based SCR (Group 1), and 26 patients received partial repair with ST-based SCR (Group 2). Functional outcomes were assessed using the Constant score, visual analogue scale (VAS) for pain and American Shoulder and Elbow Surgeons (ASES) score. Shoulder range of motion and anatomical parameters, including the acromiohumeral distance (AHD), were measured. Re-tear rates were evaluated by magnetic resonance imaging at the final follow-up. Results: Both groups demonstrated significant postoperative improvements in the VAS, Constant and ASES scores (p < 0.05), with no significant intergroup differences. Postoperative AHD increased in both groups, with a significantly greater increase in the ST group (p = 0.03). Re-tear rates were 16.6% in the LHBT group versus 11.5% in the ST group (p = 0.04), indicating superior structural integrity with the ST. Conclusion: ST and LHBT-based SCR provide comparable functional improvements in patients with massive irreparable rotator cuff tears. ST may offer enhanced structural stability and lower re-tear rates, representing a viable alternative for patients with poor tendon quality or absent biceps tendon. Long-term prospective studies are required to confirm their durability and clinical relevance.