Summary

purpose of this study is to investigate the clinical outcomes and MRI results of autologous fascia lata transplantation in massive rotator cuff tears

Abstract

Purpose

To assess minimum 2-year clinical outcomes after open biologic patch augmentation with distal fascia lata (DFL) repair in patients with irreparable large or massive rotator cuff tears (RCTs) with low-grade fatty tendon degeneration (stage 1 or 2 according to Goutallier classification)

MATERIALS & METHODS:
This study included 32 patients (24 men and 8 women) with a mean age of 57 years (range, 26 to 68 years) with massive rotator cuff tears who underwent open rotator cuff repair with patch augmentation were identified after clinical and MRI evaluation. All selected patients have undergone conservative therapy with ineffective results before surgical treatment and have persistent pain and weakness. Outcomes data collected included Constant and American Shoulder and Elbow Surgeons scores (ASES). After patch augmentation, there were no complications, no adverse reactions to the patch, and no patients required further surgery. Minimum 2-year outcome scores were available for 30 of 32 (96.3%) 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 especially the function component improved significantly when compared with their preoperative baselines (P < .05). Median patient satisfaction at final follow-up was 9/10 (range, 2 to 10). Regarding the Constant shoulder score an excellent grade was achieved in 27 patients of 32 form the baseline. Postoperative MRI at the final follow-up showed that 3 shoulders (8.3%) had retears of the repaired RC, 6 (12.5%) had graft tears but no retears of the repaired RC, and 25 (79.2%) had no graft tears or retears of the
repaired tendon; furthermore no progression of fatty degeneration was detected.

Conclusions

Biologic patch augmentation using distal fascia lata autograft was a inexpensive, safe and effective treatment method for patients with RCT with deficient rotator cuff tendons with low-grade fatty tendon degeneration.