Preliminary Results of a Consecutive Series of Large & Massive Rotator Cuff Tears Treated with Arthroscopic Rotator Cuff Repairs Augmented with Extracellular Matrix

Background:Recurrence rate of rotator cuff tears is still high despite the improvements of surgical techniques, materials used and a better knowledge of the healing process of the rotator cuff tendons. Large to massive rotator cuff tears are particularly associated with a high failure rate, especially in elderly. Augmentation of rotator cuff repairs with extracellular matrix or synthetic patches has gained popularity in recent years with the aim of reducing failure.
The aim of this study was to investigate the outcome of rotator cuff repairs augmented with denatured extracellular matrix in a series of patients who underwent arthroscopic rotator cuff repair for large to massive tears.
Methods Ten consecutive patients, undergoing arthroscopic rotator cuff repair with extracellular matrix augment for large and massive tears, were prospectively enrolled into this single surgeon study. All repairs were performed arthroscopically with a double row technique augmented with extracellular matrix. Oxford Shoulder Score, Constant Score and pain visual analogue scale (VAS) were used to monitor the shoulder function and outcome pre-operatively and at three, six and 12-month follow-up. Minimum follow up was tree months. Mean follow up was 7 months.
Results Mean Constant score improved from 53 (SD=4) pre-operatively to 75 (SD=11) at final follow up. Mean Oxford score also increased from 30 (SD=8) pre-operatively to 47 (SD=10) at the final follow up. The visual analogue scale (VAS) improved from seven out of 10 (SD=2) preoperatively to 0.6 (SD=0.8) at final follow up. Additionally, there was significant improvement at three months mark in Constant score.
Conclusion: Arthroscopic repair and augmentation of large and massive rotator cuff tears with extracellular matrix patch has good early outcome.
Keywords: Augmentation, Double-row technique, Extracellular matrix, Owl technique, Patch, Rotator cuff repair, Rotator cuff tear, Scaffold, Tendinopathy
(Arch Bone Jt Surg. 2017; 5(1): 14-21.)