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KMID : 1036220230260040406
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Clinics in Shoulder and Elbow
2023 Volume.26 No. 4 p.406 ~ p.415
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Radiologic and clinical outcomes of an arthroscopic bridging graft for irreparable rotator cuff tears with a modified Mason-Allen stitch using a plantaris tendon autograft: a case series with minimum 2-year outcomes
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Seok Hyun-Gyu
Park Sam-Guk
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Abstract
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Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT.
Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon.
Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (?3.0, P=0.003), ASES (24.9, P=0.002), D ASH (?20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported.
Conclusions: An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.
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KEYWORD
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Autograft, Plantaris muscle, Rotator cuff tear
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