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KMID : 1037920170040020066
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Arthroscopy and Orthopedic Sports Medicine
2017 Volume.4 No. 2 p.66 ~ p.73
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Mid-term results of arthroscopic porcine dermal xenograft augmentation for irreparable massive rotator cuff tears: a 3-year follow-up study
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Cheon Sang-Jin
Lee Ji-Min
An Sung-Jin
Lee Hyo-Yeol
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Abstract
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Background: In this study we assessed the mid-term results of arthroscopic augmentation with porcine dermal xenografts for irreparable rotator cuff tears.
Methods: Between February 2010 and February 2012, ten patients with irreparable rotator cuff tears were treated with arthroscopic augmentation with porcine dermal xenografts. All patients were followed up for at least three years. Clinical scores the University of California, Los Angeles (UCLA) scoring system, the Constant score, and the American Shoulder and Elbow Surgeons (ASES) shoulder score were evaluated both preoperatively and postoperatively in all patients. We evaluated repair status in terms of radiological outcome through magnetic resonance imaging after a mean 10.3 months of operation.
Results: The study population consisted of seven men and three women with a mean age of 64.9 years (range, 53?72 years) and a mean follow-up of 42.5 months (range, 36.2?47.1 months). The clinical outcome significantly improved for all patients. The mean UCLA score increased from 15.50 preoperatively to 30.10 postoperatively (P < 0.001). The mean Constant score improved from 59.80 to 83.90 (P = 0.001), and the mean ASES score, from 58.60 to 85.30 (P = 0.001). However, there were no significant differences between the intact group and the retear group in terms of clinical results. Magnetic resonance imaging at the follow-up examinations demonstrated patch continuity between the native cuff and the greater tubercle in five patients (50%). We did not observe any significant difference between the intact group and retear group in terms of, preoperatively, the size of the tear, degree of muscle atrophy, smoking status, use of steroids, and, postoperatively, the rehabilitation protocol.
Conclusion: We found that arthroscopic repairs using porcine dermal xenografts for irreparable massive rotator cuff tears is associated with improved clinical outcome in most patients, despite a retear rate of 50%. Thus, we conclude that porcine dermal patch augmentation can be one of the treatment options for patients with either reparable subscapularis or infraspinatus.
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KEYWORD
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Arthroscopic repair, Irreparable massive rotator cuff tear, Porcine dermal xenograft
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