2017 ISAKOS Biennial Congress ePoster #2233

 

“Tissue-Bridge” Technique to Repair Rotator Cuff Tear

Yaohua He, MD, Shanghai, Shanghai CHINA
Shanghai Jiotong University, Shanghai, Shanghai, CHINA

FDA Status Not Applicable

Summary

To evaluate the technique of arthroscopic biceps tendon transposition “Tissue-bridge” technology reconstruction irreparable rotator cuff tear and its outcomes

Abstract

Background

There are a variety of treatment methods for irreparable rotator cuff tear, but the most effective way is still being explored. The purpose of this study is to evaluate the technique of arthroscopic biceps tendon transposition “Tissue-bridge” technology reconstruction irreparable rotator cuff tear and its outcomes.

Material From May 2014 to January 2016, eleven cases were included (3 males, 8 females. Aged 59 to 67 years, mean age 62.5 years). For cases with other shoulder complications such as shoulder instability or other diseases were excluded.

Methods

All patients have shoulder pain and limited ROM. MRI diagnosis was huge retracted rotator cuff tears (rotator cuff fatty infiltration Goutallier grade 3 to 4). After arthroscopic synovial debridement, LHB tendon was used as a “tissue-bridge” in rotator cuff repair. Generally, we fix the biceps with the suture anchors in two ways, in situ or translocation, depending on the shape of the rotator cuff tear. Then we stitch the rotator cuff on the biceps tendon with no tension, and fix the rotator cuff to the footprint area. Shoulder ROM, pain, ASES, Constant, and UCLA score were recorded before surgery and in the postoperative follow-up. All the data and functional status were statistically analyzed.

Results

With an average follow-up of 12 months (ranged from 6 to 18 months), all patients experienced convalescent period successfully. At final follow-up visits, the ASES, Constant and UCLA score were found to have improved significantly from 22.7±5.2, 44.2±15.7, and 12.3±4.7 to 32.8±2.0, 87. 0±12.5 and 38.2±3.9, respectively (P <0.05). No retear or fixation failure is found in the 6 and 12 months MRI assessment postoperatively.

Discussion

The advantages of our technique are that we use LHB tendon as a natural patch to repair rotator cuff, avoiding the use of artificial patch or other implants which may reduce the incidence of infection and rejection. The functions of LHB tendon as depressor of humeral head and GH joint stabilizer are retained in this procedure. The disadvantages are the small numbers and limited follow-up periods. At the same time, the impact of the fixed biceps tension is unclear. Longer follow-up and biomechanics studies are needed to verify furtherly and thoroughly.

Conclusion

“Tissue-bridge" technique to repair rotator cuff tear shows optimistic curative effect and can be used as a new method of treating irreparable rotator cuff tear.

Key words Arthroscopy; Rotator cuff tear; Biceps tendon; Tendon transposition