Stephen S. Burkhart, M.D. Shoulder Innovation Research Award Paper: Balloon Subacromial Spacer vs. Partial Repair for Massive Rotator Cuff Tears: A Randomized Trial

Background The surgical management of massive rotator cuff tears remains a challenge. It is suggested that, even in a massive tear that appears irreparable, attempting to repair it as much as possible can be helpful in improving functional outcomes. However the results can be short term and variable. The purpose of our study was to determine if human tissue allograft bridged repair of massive irreparable rotator cuff tears to achieve a complete repair produces similar outcomes compared to partial repair alone. Methods We prospectively reviewed outcome scores in 13 patients who underwent partial repair alone for massive irreparable rotator cuff tears and compared them to 13 patients who had partial repairs bridged with allograft. Oxford and Constant scores were compared pre-operatively and at a minimum follow-up of 2 years (range 2 years to 5 years). Results The mean improvement in the Constant score at final follow-up compared to pre-operative scores was 27.7 points in the partial repair group and 42.8 points in the allograft group ( p < 0.01). The Oxford Shoulder Score improved mean of 19.3 points in the partial repair group and 29 points in the allograft group ( p < 0.02) at 2 years. Conclusions Human tissue matrix allograft provides a better outcome for open bridging of irreparable rotator cuff tears than partial repair alone.

Download Full-text

Massive Rotator Cuff Tears: Results of Arthroscopic Partial Repair (SS-53)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/s0749-8063(07)60051-6 ◽

2002 ◽

Vol 18 (5) ◽

pp. 43-44 ◽

Cited By ~ 1

Author(s):

Armin M. Tehrany ◽

Stephen S Burkhart

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tears ◽

Partial Repair ◽

Massive Rotator Cuff Tears

Download Full-text

Irreparable Large to Massive Rotator Cuff Tears With Low-Grade Fatty Degeneration of the Infraspinatus Tendon: Minimum 7-Year Follow-up of Fascia Autograft Patch Procedure and Partial Repair

The American Journal of Sports Medicine ◽

10.1177/03635465211043501 ◽

2021 ◽

pp. 036354652110435

Author(s):

Daisuke Mori ◽

Kazuha Kizaki ◽

Noboru Funakoshi ◽

Fumiharu Yamashita ◽

Yasuyuki Mizuno ◽

...

Keyword(s):

Logistic Regression ◽

Rotator Cuff ◽

Clinical Outcomes ◽

Fatty Degeneration ◽

Rotator Cuff Tears ◽

Low Grade ◽

Partial Repair ◽

Massive Rotator Cuff Tears ◽

Infraspinatus Tendon

Background: In shoulders with irreparable massive rotator cuff tears (RCTs) with high-grade fatty degeneration (Goutallier stage 3 or 4) of the supraspinatus tendon and low-grade fatty degeneration (Goutallier stage 1 or 2) of the infraspinatus tendon (ISP), arthroscopic patch grafting (PG) has been reported as superior to partial repair (PR) regarding the ISP retear rate at short-term to midterm follow-up. However, the longer term outcomes are unclear. Purpose: To compare clinical and structural outcomes in the PG and PR groups at a minimum of 7 years postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 24 patients in the PG group and 24 patients in the PR group. We primarily used the Constant score for clinical outcomes and performed magnetic resonance imaging for structural outcomes in the PG and PR groups. The risk factors for a retear of the ISP were identified by univariate and multivariate (forward stepwise selection method) logistic regression analyses. We primarily compared values at midterm follow-up (<4 years) with values at the final follow-up (minimum 7 years) for each patient. Results: The mean midterm and final follow-up times for the PG group were 41.0 and 95.1 months, respectively, compared with 35.7 and 99.3 months, respectively, for the PR group. We found significant differences for the midterm and final follow-up Constant total scores in the PG and PR groups (midterm follow-up: 79.1 vs 69.9, respectively [ P = .001]; final follow-up: 76.0 vs 65.3, respectively [ P = .006]) and in the Constant strength scores (midterm follow-up: 14.6 vs 8.5, respectively [ P < .001]; final follow-up: 13.1 vs 8.3, respectively [ P = .001]). Treatment group (PR) was a significant predictor of an ISP retear in the logistic regression analysis (odds ratio, 3.545; P = .043). Conclusion: Patients with low-grade massive RCTs treated with PG or PR improved significantly in terms of clinical outcomes at the midterm and final follow-up time points. However, Constant scores were significantly better in the PG group at the final follow-up.

Download Full-text