Patient-reported outcome measures (PROMs) of superior capsular reconstruction in irreparable rotator cuff tears: A systematic review and meta-analysis

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Introduction Superior capsular reconstruction (SCR) has emerged as a joint-preserving surgical option for irreparable rotator cuff tears (IRCTs), though its impact on patient-reported outcome measures (PROMs) remains variably reported. Methodology This systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261327201). Electronic databases including PubMed, Cochrane Library, DOAJ, and Google Scholar were searched from inception to identify studies evaluating SCR in adult patients with IRCTs. Two reviewers conducted data extraction and the risk of bias assessment (ROBINS-I tool). The meta-analysis was done through a random-effects model to estimate standardized mean differences (SMDs) and pooled proportions with 95% confidence limits. Results A total of 18 studies involving 607 shoulders were included. SCR demonstrated significant improvements in ASES score (SMD = 3.86, 95% CI: 2.25–5.48, p < 0.0001), Constant–Murley score (SMD = 2.41, 95% CI: 0.42–4.39, p = 0.0175), and VAS pain (SMD = −2.65, 95% CI: −3.51 to −1.80, p < 0.0001). Forward flexion improved significantly (SMD = 3.05, 95% CI: 1.37–4.73, p = 0.0004), as did external rotation (SMD = 1.05, 95% CI: 0.29–1.81, p = 0.0070). The pooled graft integrity rate was 73.3% (95% CI: 61.1–85.5), with a complication rate of 12.1% (95% CI: 3.1–21.2), revision rate of 4.1% (95% CI: 1.7–6.4), and patient satisfaction rate of 83.8% (95% CI: 73.6–94.0). Conclusion SCR significantly improves pain, function, and PROMs in IRCTs. It is a good joint-preserving surgical procedure, but more high-quality research is required to allow optimizing patient selection and outcomes.

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