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This study compared the clinical and radiological outcomes of arthroscopic rotator cuff repair (aRCR) and arthroscopic superior capsular reconstruction (aSCR) for managing massive rotator cuff tears (MRCTs). A total of 163 MRCT cases were retrospectively reviewed, with 102 undergoing aRCR and 61 undergoing aSCR using fascia lata autograft. Propensity score matching was applied, resulting in 33 cases in each group. Clinical outcomes, including range of motion (ROM) and pain visual analog scale (pVAS) score, significantly improved in both groups. However, aSCR demonstrated superior outcomes, with improved forward flexion, pVAS score, acromiohumeral distance (AHD), and a higher healing rate of 87.9% and 60.6% for aSCR and aRCR, respectively. Therefore, aSCR may be a preferable treatment option for MRCTs compared to aRCR.
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