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REPAIR OF NON-REPAIRABLE MASSIVE ROTATOR CUFF TEARS USING AN EMBROIDERED POLYESTER CUFF REINFORCEMENT: A PRELIMINARY STUDY OF 13 CASES



Abstract

We report the results of a method of reconstructing massive rotator cuff (RC) tears and reinforcing the repaired RC tendons with re-tensioning of the cuff to effect reconstruction of tears which were previously considered non-repairable.

Methods A consecutive series of 37 patients (19 men) with a mean age of 61 years (range 45–80) are reported. Mean duration of pre-op symptoms was 19 (4–36) months and the mean pre-op Constant Score (CS) was 41. Insertion involved anchoring the device to the undersurface of the retracted RC tendon with Ethibond sutures, passing the other end of the device through a tunnel under the greater tuberosity and anchoring the device, under tension, to the proximal humerus with 1 or 2 screws. The proximal fixation is similar to “spot-welding” while the distal fixation is a “flexible plate” fixation.

Results The follow-up mean CS (minimum 10/12 post-op) was 54. There has been one deep infection. Two had MRI confirmed re-rupture of the RC. One case of a stiff shoulder required manipulation. This embroidered polyester augmentation device is resistant to re-tears and integrates well with medium term re-centering of the humeral head which had been superiorly displaced pre-op.

Correspondence should be addressed to BESS c/o BOA, 35-43 Lincoln’s Inn Fields, London WC2A 3PE