Arthroscopic Superior Capsular Reconstruction With Minimally Invasive Harvested Fascia Lata Autograft - Clinical Outcomes and Survivorship of the Autograft Analysis

Task 1 - Prospective evaluation of:

1. The mid-term shoulder outcomes of ASCR with minimally invasive harvested fascia lata autograft The objective of this task is to establish the 3 years postoperative clinical and radiological shoulder outcomes of FL-ASCR with minimally invasive harvesting. The secondary purpose of this task is to test if the FL-ASCR outcomes remain constant after the 2-year evaluation.

Therefore, the FL-ASCR patients included in this study will have completed the preoperative, 6-month and 2-year postoperative evaluations and will undergo a 3-year postoperative evaluation of:

1. Bilateral shoulder active range of motion (ROM): elevation, abduction and external rotation (with the arm at the side), measured in degrees with the use of an analogic goniometer; and internal rotation, defined as the highest vertebral body that the patient's thumb can reach, converted afterwards to a scale of 1-5 points: lateral thigh=0; buttock=1; sacrum=2; lumbar=3; 12th thoracic vertebra=4; 7th thoracic vertebra=5.);
2. Bilateral shoulder strength (supraspinatus, infraspinatus, subscapularis and teres minor) measured in kilograms with the use of a digital dynamometer;
3. Bilateral functional shoulder scores: the simple shoulder test (SST, 1-12 points), the subjective shoulder value (SSV, 0-100%) and the constant score (CS, 1-100 points).
4. True anteroposterior shoulder view radiograph of the affected shoulder: the acromiohumeral interval (AHI), considering the distance between the top of the humeral head and the undersurface of the acromion, measured using a software measurement tool (PACS, Agfa HealthCare); the RCT arthritis will be graded according to the Hamada revised radiographic classification.
5. The donor site morbidity impact of FL-ASCR with minimally invasive harvesting The objective of this task is to establish the 3-year donor site morbidity subjective impact of FL-ASCR with minimally invasive harvesting. The secondary aim of this task is to test our hypothesis that the subjective impact of the donor site morbidity after FL-ASCR does not change significantly from the 2-year to the 3-year evaluation. Therefore, at the 3-year evaluation, the patients will be required to answer to the same three closed-ended questions that were asked at the 2-year evaluation to assess the donor site morbidity's impact on the patient's overall satisfaction of the surgical procedure: "Does the harvested thigh bother you?", "Does your shoulder surgery's end result compensate for your thigh's changes?", "Would you undergo the same surgery again?". Accordingly, the patients will also be asked asked, in a closed-ended questionnaire, if they noticed any of the following donor site changes: deformity, pain, numbness and specific donor site-related claudication.

Task 2 - Analysis of the mid-term graft integrity on the 3-year postoperative magnetic resonance imaging (MRI) to determine the graft mid-term survivorship

The objective of this task is to determine the 3-year postoperative survivorship of the graft, establishing the fascia lata superior capsular graft tearing rate and the most frequent site of graft failure at 3 years. A 1.5 Tesla MRI scanner (Siemens Magnetom, U.S.A.) will be used to acquire images in the coronal [proton density fat-saturated (PD FAT-SAT) and T1-weighted], sagittal (PD FAT-SAT and T2 FAT-SAT) and axial (T2* and PD) planes. We and, after blinding, two other independent experienced musculoskeletal radiologists will assess the MRI-images from each patient, in order to: