Objective: Massive irreparable rotator cuff tears cause severe shoulder dysfunction. Superior capsular reconstruction (SCR) is effective, but optimal graft material is controversial; combined autologous fascia lata and LARS ligament needs validation.
Methods: We retrospectively analyzed 30 patients who underwent superior capsular reconstruction using autologous fascia lata combined with LARS ligament for massive irreparable rotator cuff tears between November 2023 and May 2025. We evaluated American Shoulder and Elbow Surgeons (ASES) scores, University of California, Los Angeles (UCLA) scores, Constant-Murley (CMS) scores, visual analogue scale (VAS) scores, shoulder range of motion, and acromiohumeral distance (AHD). Paired t-tests or Wilcoxon signed-rank tests were used to compare preoperative and postoperative outcomes, and p < 0.05 was considered statistically significant. And analyzed the complications after the operation.
Results: All 30 patients were followed up for a mean duration of months (12.35 ± 2.13). Seven cases involved isolated irreparable supraspinatus tendon tears, 19 cases had combined supraspinatus and infraspinatus tendon tears, and 4 cases included subscapularis tendon tears. In 3 cases, the long head of the biceps tendon was fixed to replace the anterior aspect of the supraspinatus tendon; in the remaining cases, the long head of the biceps tendon was transected. No glenoid fossa deformity was observed. At final follow-up, all functional scores improved significantly (all p < 0.05): ASES score increased from 31.04 ± 4.26 to 82.12 ± 3.23, UCLA score from 11.83 ± 4.15 to 30.44 ± 1.83, and CMS score from 32.44 ± 6.72 to 83.42 ± 4.75. The VAS score decreased from 5.84 ± 0.87 to 1.22 ± 0.42 (p < 0.05). Active range of motion in shoulder forward flexion, abduction, external rotation, and internal rotation improved significantly (all p < 0.05). Postoperative AHD significantly increased from 4.25 ± 0.41 mm to 10.15 ± 0.16 mm (p < 0.05). No complications such as wound infection, nerve injury, anchor loosening, lateral thigh pain, hematoma, or numbness occurred.
Conclusion: For patients with massive irreparable rotator cuff tears, superior capsular reconstruction using autologous fascia lata combined with LARS ligament effectively alleviates shoulder pain, enhances glenohumeral stability, and improves shoulder function.
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2026 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.
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