2017 ISAKOS Biennial Congress ePoster #2235
Change of MRI Findings after Arthroscopic Rotator Cuff Repair with Fascia Lata Graft Augmentation
Takeshi Kokubu, MD, PhD, Kobe JAPAN
Yutaka Mifune, MD, PhD, Kobe JAPAN
Atsuyuki Inui, MD, PhD, Kobe JAPAN
Fumiaki Takase, MD, Kobe JAPAN
Yasuhiro Ueda, MD, Kobe JAPAN
Takeshi Kataoka, MD, Kobe, Hyogo JAPAN
Takashi Kurosawa, MD, Kobe JAPAN
Ryosuke Kuroda, MD, PhD, Kobe, Hyogo JAPAN
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, JAPAN
FDA Status Not Applicable
The clinical outcomes of the fascia lata graft augmentation in large and massive rotator cuff tears which were repaired with good integrity on MRI were significantly improved.
A retear after surgical repair of large and massive rotator cuff tears have been reported as one of the most common complications. For prevention from retear of the repaired rotator cuff, we have performed single row repairs with graft augmentation of fascia lata in order to reduce a tension at the tendon-bone repair site. The technique using graft augmentation of fascia lata showed excellent clinical outcomes in large and massive rotator cuff tears. The purpose of this study was to evaluate MRI findings until two years after the fascia lata graft augmentation.
Eighteen fascia lata graft augmentations for large and massive rotator cuff tears have been performed from December 2011 to April 2014. Four cases who had retears by postoperative 6 months and four cases who could not be followed by MRI examinations were excluded from the study. Ten patients (7 males, 3 females, mean age 65.1 years old, 6 large tears, 4 massive tears) without retears who were able to undergo MRI follow-up for postoperative two years were included in this study. MRI was taken at 3, 6, 12, and 24 months after the surgery. Cuff integrity according to Sugaya’s classification and muscle atrophy of the supraspinatus were analyzed. Clinical outcomes were also evaluated using UCLA score, Japanese Orthopaedic Association (JOA) score, and Constant score.
MRI revealed improvement of the cuff integrity until one year; type I and II of Sugaya’s classification were 2 and 8 cases at postoperative 3 months, 4 and 6 cases at 6 months, 6 and 4 cases at one year, and 6 and 4 cases at two years, respectively. Mean atrophy rates of the supraspinatus were 55.2% before the operation, 51.8% at postoperative three months, 52.5% at six months, 53.4% at one year, and 55.3% at two years. The muscle atrophy of the supraspinatus has not changed during the two-year follow-up. The overall mean UCLA score, JOA score, and Constant score significantly improved from 17.9 to 26.4 points, from 68.7 to 90.0 points, and 46.6 to 69.1 points, respectively.
MRI revealed improvement of the cuff integrity until postoperative one year, but no improvement after one year. Atrophy of the supraspinatus did not change during the follow-up. However, the clinical outcomes of the fascia lata graft augmentation in large and massive rotator cuff tears which were repaired with good integrity on MRI were significantly improved.