Summary

Additional LHBT augmentation for massive and irreparable RCT provides lower retear rate and better outcome then partial repair only

Abstract

Introduction

Management of massive rotator cuff tears (MRCT) is associated with high rates of failure. The long head of the biceps tendon augmentation (LHBTA) by reinforcement of the reconstruction and additional blood supply may improve healing and provide better outcome than partial repair only.

Aim

The aim of this study was to compare clinical and radiological outcomes after treatment of massive and irreparable rotator cuff tears by two methods: partial repair (PR) and PR with long head of the biceps tendon augmentation (PRLHBTA). It was performed to answer the question: does additional LHBTA improve the results?

Material And Methods

Patients with irreparable supraspinatus muscle (SSP) tear, and complete infraspinatus muscle (ISP) tear were included in the retrospective, comparative study and divided into 2 groups according to method of treatment. Irreparability was defined as inability to achieve repair of the SSP after complete release with = 3 in Goutallier classification and stage 3 in Patte classification. Clinical assessment tools consisted of range of motion (ROM), strength measurements, Constant (CM) and SST Scores. Radiological assessment consisted of Acromio-humeral index (AHI), Hamada, and Sugaya scores and Goutallier classification for SSP and ISP. Statistical significance was estimated on 0.05

Results

Data for 60 patients (30 in each group) with mean age 62.5 years and mean follow-up 34.5 months was analyzed. Retear rate for PRLHBTA was 43.3% vs 73.3% for PR (p=0.036). In the final examination statistically significant differences favors PRLHBTA was found in CM 76.2±0.9 vs 70.9±11.5 (p=0.044), Sugaya vs 3.5±1.1 vs 4.1±0.9 p=0.035 and AHI 5.8±2mm vs 4.7±1.3 (p=0.021). There were no significant differences in ROM, arm strength, Hamada, SST and Goutallier scores.

Conclusion

PR with LHBTA for irreparable MRCT provides lower retear rate and better radiological and partially functional results then PR only.