Maximilian Petri1, Ryan J Warth2, Marilee P Horan2, Joshua A Greenspoon2, Peter J Millett3. 1. Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A. 2. Steadman Philippon Research Institute, Vail, Colorado, U.S.A. 3. Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.. Electronic address: drmillett@thesteadmanclinic.com.
Abstract
PURPOSE: To assess minimum 2-year clinical outcomes after open revision biologic patch augmentation in patients with massive rotator cuff retears who had deficient rotator cuff tendons with healthy rotator cuff muscles. METHODS: Patients with massive posterosuperior rotator cuff retears who underwent open revision rotator cuff repair with patch augmentation were identified from a surgical registry. Outcomes data collected included American Shoulder and Elbow Surgeons; Quick Disabilities of the Arm, Shoulder and Hand; Single Assessment Numeric Evaluation; and Short Form-12 Physical Component Summary scores along with postoperative patient satisfaction, and activity modification. RESULTS: There were 10 men and 2 women (13 shoulders, 1 bilateral) with a mean age of 57 years (range, 26 to 68 years). All patients had at least one prior arthroscopic rotator cuff repair. After patch augmentation, there were no complications, no adverse reactions to the patch, and no patients required further surgery. One patient (7.7%) with 4 prior cuff repairs had a documented posterosuperior retear on magnetic resonance imaging 2 months after repair. Minimum 2-year outcome scores were available for 12 of 13 (92.3%) shoulders after a mean follow-up period of 2.5 years (range, 2.0 to 4.0 years). The ASES score improved by 21.5 points. Although the pain component of the ASES score and the total ASES score did not improve significantly, the function component of the ASES score improved significantly when compared with their preoperative baselines (P < .05). Median patient satisfaction at final follow-up was 9/10 (range, 2 to 10). CONCLUSIONS: Biologic patch augmentation with human acellular dermal allograft was a safe and effective treatment method for patients with massive rotator cuff retears with deficient posterosuperior rotator cuff tendons in the presence of healthy rotator cuff muscles. LEVEL OF EVIDENCE: Level IV, therapeutic study.
PURPOSE: To assess minimum 2-year clinical outcomes after open revision biologic patch augmentation in patients with massive rotator cuff retears who had deficient rotator cuff tendons with healthy rotator cuff muscles. METHODS:Patients with massive posterosuperior rotator cuff retears who underwent open revision rotator cuff repair with patch augmentation were identified from a surgical registry. Outcomes data collected included American Shoulder and Elbow Surgeons; Quick Disabilities of the Arm, Shoulder and Hand; Single Assessment Numeric Evaluation; and Short Form-12 Physical Component Summary scores along with postoperative patient satisfaction, and activity modification. RESULTS: There were 10 men and 2 women (13 shoulders, 1 bilateral) with a mean age of 57 years (range, 26 to 68 years). All patients had at least one prior arthroscopic rotator cuff repair. After patch augmentation, there were no complications, no adverse reactions to the patch, and no patients required further surgery. One patient (7.7%) with 4 prior cuff repairs had a documented posterosuperior retear on magnetic resonance imaging 2 months after repair. Minimum 2-year outcome scores were available for 12 of 13 (92.3%) shoulders after a mean follow-up period of 2.5 years (range, 2.0 to 4.0 years). The ASES score improved by 21.5 points. Although the pain component of the ASES score and the total ASES score did not improve significantly, the function component of the ASES score improved significantly when compared with their preoperative baselines (P < .05). Median patient satisfaction at final follow-up was 9/10 (range, 2 to 10). CONCLUSIONS: Biologic patch augmentation with human acellular dermal allograft was a safe and effective treatment method for patients with massive rotator cuff retears with deficient posterosuperior rotator cuff tendons in the presence of healthy rotator cuff muscles. LEVEL OF EVIDENCE: Level IV, therapeutic study.
Authors: Jonathan A Cook; Mathew Baldwin; Cushla Cooper; Navraj S Nagra; Joanna C Crocker; Molly Glaze; Gemma Greenall; Amar Rangan; Lucksy Kottam; Jonathan L Rees; Dair Farrar-Hockley; Naomi Merritt; Sally Hopewell; David Beard; Michael Thomas; Melina Dritsaki; Andrew J Carr Journal: Health Technol Assess Date: 2021-02 Impact factor: 4.014
Authors: A Ali Narvani; Mohamed A Imam; Ioannis Polyzois; Tanaya Sarkhel; Rohit Gupta; Ofer Levy; Paolo Consigliere Journal: Arthrosc Tech Date: 2017-05-29