Speaker: Use of superior capsular reconstruction may be declining
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SAN FRANCISCO — Results presented at the Arthroscopy Association of North America Annual Meeting showed utilization of superior capsular reconstruction has decreased among orthopedic surgeons.
“We asked surgeons why they utilized [superior capsular reconstruction] less frequently, and the most important predictor was their personal patient outcomes,” Abby C. Hankins, MS, said in her presentation here. “This was followed by false complexity and limited outcomes that are in the literature.”
Hankins and colleagues collected a 26-question survey from 260 AANA members who selected shoulder as their primary joint that focused on the utilization of superior capsular reconstruction (SCR) and biologic grafts. The survey included questions about their practice region, years in practice, volume on rotator cuff tears per year and utilization trends, according to Hankins.
“We found there was a decreased utilization of SCR in the past 5 years,” Hankins said. “Out of all the surgeons, higher-volume surgeons – those performing greater than 100 rotator cuff repairs per year – were more likely to utilize SCR,” Hankins said.
She noted surgeons who worked in a hospital setting were more likely to utilize SCR, while international surgeons performed fewer SCRs. Hankins noted surgeons who utilized SCR less frequently reported that they thought surgeons were increasing their utilization of SCR.
“We followed up by asking surgeons who utilize SCR which percentage of their irreparable cuff procedures that they would actually utilize SCR,” Hankins said. “Even after saying that they did use SCR, fewer than 4% utilized it in greater than 90% of their irreparable cases. Meanwhile, 38% reported that they utilized SCR in less than 10% of their irreparable cases.”
When it came to the use of biologic grafts, surgeons with a higher volume of patients reported the greatest utilization of any demographic group, according to Hankins.
“We asked the surgeons who did these biologic augmentations, ‘What percentage of rotator cuff repairs did you use one of these biologic grafts?’ Similar to the SCR, it was found that fewer surgeons used them in the majority of cases,” Hankins said. “Surgeons in practice greater than 10 years utilized less than 20% of their cases. The academic-setting and international surgeons also performed less utilization of biologic grafts.”
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Hankins AC, et al. Biologic graft utilization for rotator cuff surgery: Superior capsular reconstruction on the decline. Presented at: American Association of North America Annual Meeting. May 19-21, 2022; San Francisco.
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