Cédric Maillot1, Edouard Harly2, Hugues Demezon2, Jean-Charles Le Huec2. 1. Department of Orthopaedics and Spine Surgery, Pellegrin Hospital, Bordeaux, France; Department of Orthopedics Surgery, University Hospital of South Reunion Island, Saint-Pierre, Reunion, France. Electronic address: cedric.maillot@sfr.fr. 2. Department of Orthopaedics and Spine Surgery, Pellegrin Hospital, Bordeaux, France.
Abstract
BACKGROUND: This prospective study compared the outcomes after 3 different treatments for large and massive rotator cuff tears. METHODS: Patients with a diagnosis of large-to-massive rotator cuff tears were prospectively included. Patients were allocated in 3 groups: (1) arthroscopic complete repair (repair group), (2) open repair and xenograft patch augmentation (patch group), and (3) arthroscopic débridement and tenotomy of the long head of the biceps (débridement group). Patients were evaluated preoperatively and postoperatively at 3, 6, 12 and 24 months. The primary outcome measure was the Constant-Murley score. RESULTS: The study included 32 consecutive patients. The mean improvement in the Constant-Murley score was +29.1 for the repair group (P < .01), +32.2 for the patch group (P < .01), and +20.1 for the débridement group (P < .01) at the final follow-up examination. No differences were found between the repair and patch groups, but the difference became significant between the débridement group and the patch group (P < .001) and also between the débridement group and the repair group (P < .002) at 12 months and the final follow-up. Moreover, 5 complications occurred in 11 patients in the patch group, whereas there was only 1 complication in the repair group and no complications in the débridement group. CONCLUSION: The use of porcine dermis patches to augment repairs of massive and irreparable rotator cuff tears is not recommended because there is no benefit compared with repair without augmentation and patches result in more complications.
BACKGROUND: This prospective study compared the outcomes after 3 different treatments for large and massive rotator cuff tears. METHODS:Patients with a diagnosis of large-to-massive rotator cuff tears were prospectively included. Patients were allocated in 3 groups: (1) arthroscopic complete repair (repair group), (2) open repair and xenograft patch augmentation (patch group), and (3) arthroscopic débridement and tenotomy of the long head of the biceps (débridement group). Patients were evaluated preoperatively and postoperatively at 3, 6, 12 and 24 months. The primary outcome measure was the Constant-Murley score. RESULTS: The study included 32 consecutive patients. The mean improvement in the Constant-Murley score was +29.1 for the repair group (P < .01), +32.2 for the patch group (P < .01), and +20.1 for the débridement group (P < .01) at the final follow-up examination. No differences were found between the repair and patch groups, but the difference became significant between the débridement group and the patch group (P < .001) and also between the débridement group and the repair group (P < .002) at 12 months and the final follow-up. Moreover, 5 complications occurred in 11 patients in the patch group, whereas there was only 1 complication in the repair group and no complications in the débridement group. CONCLUSION: The use of porcine dermis patches to augment repairs of massive and irreparable rotator cuff tears is not recommended because there is no benefit compared with repair without augmentation and patches result in more complications.
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: Jonathan D Hughes; Brian Davis; Emily Whicker; Gregory R Sprowls; Lindsay Barrera; Ashkan Baradaran; Soheil Sabzevari; Jeremy M Burnham; Anup A Shah; Albert Lin Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-08-16 Impact factor: 4.114
Authors: Philipp Moroder; Aaron Chamberlain; Stefan M Gabriel; Marc C Jacofsky; Mehmet Z Sengun; David B Spenciner; John M Tokish; Lucca Lacheta Journal: Orthop J Sports Med Date: 2022-05-23
Authors: Teemu V Karjalainen; Nitin B Jain; Juuso Heikkinen; Renea V Johnston; Cristina M Page; Rachelle Buchbinder Journal: Cochrane Database Syst Rev Date: 2019-12-09
Authors: Mathew Baldwin; N S Nagra; Gemma Greenall; Andrew J Carr; David Beard; J L Rees; Amar Rangan; Naomi Merritt; Melina Dritsaki; Sally Hopewell; Jonathan Alistair Cook Journal: BMJ Open Date: 2020-12-07 Impact factor: 2.692
Authors: André Luís Lugnani de Andrade; Thiago Alves Garcia; Henrique de Sancti Brandão; Amanda Veiga Sardeli; Guilherme Grisi Mouraria; William Dias Belangero Journal: Orthop J Sports Med Date: 2022-03-24