Summary

Human dermal allograft augmentation and bridging for repair of large/massive rotator cuff tears shows promising results

Abstract

Introduction

Arthroscopic repair of irreparable large/massive rotator cuff tears is a difficult and challenging problem for shoulder surgeons. There are poor outcomes reported in literature, especially in old patients after revision surgery. The surgical technique of bridging reconstruction of the rotator cuff using various biologic and synthetic grafts seems attractive and promising in current orthopaedic practice.

Purpose

The purpose of this study was to retrospectively analyze prospectively collected data of both clinical and radiological results of patients with irreparable large or massive rotator cuff tears that required arthroscopic reconstruction using bridging human dermal allograft (Graft-Jacket).

Materials And Methods

Between 2010 and 2015, 60 patients underwent arthroscopic repair of irreparable large/massive rotator cuff tear using Graft-Jacket. Patients were clinically evaluated pre and postoperatively. The Western Ontario Rotator Cuff (WORC) questionnaire was used. The x-rays and the pre and postoperative magnetic resonance imaging (MRI) scans were reviewed. The average follow up was 2 years.

Results

42 patients were males and 18 females, with mean age 57.76 years. The mean pre and postoperative WORC scores were 36.02 and 80.8 respectively, with significant advancement in both male and female patients (p=0.017 and p=0.005, respectively). The mean postoperative active shoulder range of motion was forward flexion 159o, abduction 153o, internal rotation 73o and external rotation 54o. There were no early complications. Late complications included 5 patients with partial nonhealing of graft as seen on MRI, and 3 complete graft failures requiring revision to another bridging GraftJacket

Conclusions

Arthroscopic repair of irreparable rotator cuff tears using bridging Graft-Jacket demonstrates promising results in an average of 2 year follow up.