Reconstrucción de la cápsula superior en las roturas irreparables del manguito mediante injerto autógeno de isquiotibiales

espanolObjetivo El objetivo de este estudio es investigar los resultados clinicos y los hallazgos radiograficos tras la reconstruccion de la capsula superior (RCS) en las roturas irreparables posterosuperiores sintomaticas (RIPS) del manguito de los rotadores mediante una nueva tecnica de RCS utilizando injerto autogeno de isquiotibiales. Material y metodos Desde 2014 hasta 2016, 8 hombros en 8 pacientes (edad media de 59,6 anos) con RIPS fueron tratados con la RCS utilizando injerto autogeno de isquiotibiales. El examen fisico, Rx y RM fueron realizados antes de la cirugia y a los 12 meses. Se ha realizado un analisis descriptivo de las variables y se ha utilizado test no parametrico de los signos para comparar las medidas tomadas antes de la cirugia y a los 12 meses. Resultados Encontramos una mejoria en el test de Costant: de 49 antes de ser intervenido a 77,25 al ano de la RCS. La media de flexion activa aumento de forma significativa de 99,3° a 142,5°. La distancia media HA preoperatoria aumento de 5,25mm (rango de 3 a 7mm) antes de la cirugia a 8,18mm (rango de 6 a 10,5) tras la RCS. No hubo roturas del injerto durante el seguimiento Conclusion La RCS con injerto de isquiotibiales mejora la funcion del hombro en las RIPS. Es una tecnica alternativa al tratamiento de dichas lesiones sin cerrar las puertas a otras cirugias. EnglishObjective The aim of this study was to investigate the clinical results and radiographic findings after superior capsular reconstruction (SCR) of postero-superior symptomatic irreparable rotator cuff tears (PSIRCT) using a new SCR technique using autologous hamstring graft Material and methods From 2014 to 2016, 8 shoulders of 8 patients (mean age 59.6 years) with PSIRCT underwent SCR using autologous hamstring graft. Physical examination, X-ray and MRI were performed before the surgery and 12 months after it. A descriptive analysis was performed of the variables, and the non-parametric test of signs comparing the measurements taken before the operation and 12 months after it. Results We found an improvement in the Constant test from 49 before the SCR to 77.25 one year after the operation. The mean active flexion significantly increased from 99.3° to 142.5°. The mean preoperative AH distance increased from 5.25 (range from 3 to 7) before surgery to 8.18 (range from 6 to 10.5) after the SCR. There were no tears of the graft during follow-up. Conclusion SCR with a hamstring graft improves the function of the shoulder in PSIRCT, and is an alternative technique for treating these injuries without closing the door to other types of surgery.