Summary

This reinforcement method with a bovine-derived collagen patch for partial thickness rotator cuff tears requires only sling fixation postoperatively, allowing for early rehabilitation, which leads to quicker recovery in range of motion and muscle strength, potentially enabling an earlier return to social activities compared to the conventional suture bridge repair.

Abstract

Introduction

For partial-thickness rotator cuff tears, the common practice is to convert them to full-thickness tears and then repair them using anchors with suture bridge techniques. However, we have been using a technique that reinforces the tear without converting it to a full-thickness tear, utilizing a bovine-derived collagen patch. This report compares the short-term postoperative outcomes and postoperative cuff integrity between the patch reinforcement group and the conventional suture bridge group.
Subjects and Methods: We studied 43 cases diagnosed with isolated supraspinatus partial tears who had undergone arthroscopic surgery and had been followed up for more than one year postoperatively. The patch group, which was reinforced with a bovine-derived collagen patch, consisted of 21 cases, while the control group, converted to a full-thickness tear and fixed with a suture bridge, consisted of 22 cases. In the patch group, the partial tear was primarily repaired with a soft anchor, then covered and fixed with a patch using staples. Postoperative fixation involved using only a sling. In the control group, the tear was converted to a full-thickness tear and repaired using a suture bridge. Postoperative fixation required wearing a soft abduction brace for one month. We measured and statistically compared the range of motion at 3 and 6 months postoperatively and isometric muscle strength at 6 months postoperatively between the two groups. Additionally, MRI was performed at 3 and 6 months postoperatively to evaluate cuff integrity, and the presence of retears was assessed using the Sugaya classification.

Results

At 3 months postoperatively, the patch group showed significant improvement in flexion, abduction, and internal rotation compared to the control group, but there was no significant difference at 6 months postoperatively. At 6 months postoperatively, the patch group had significantly better abduction strength compared to the control group. Regarding cuff integrity, no retears were observed in the patch group, while two cases of retears were observed in the control group.

Discussion

The patch method requires only sling fixation postoperatively, allowing for early rehabilitation, which leads to quicker recovery in range of motion and muscle strength, potentially enabling an earlier return to social activities.