Achilles Tendon Allograft for Superior Capsule Reconstruction in Irreparable Massive Rotator Cuff Tears
| Autor: | Dae Suk Yang, Won Sik Choy, Han Gyeol Choi, Young Tak Yu, Woo Suk Kim, Kwang Won Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Visual analogue scale medicine.medical_treatment Rotator cuff tear Synovectomy Achilles Tendon Rotator Cuff Injuries Surveys and Questionnaires medicine Humans Orthopedics and Sports Medicine Rotator cuff Muscle Strength Range of Motion Articular Aged Pain Measurement Retrospective Studies Achilles tendon medicine.diagnostic_test Achilles tendon allograft business.industry Capsule Magnetic resonance imaging Middle Aged Plastic Surgery Procedures Allografts Surgery medicine.anatomical_structure Irreparable Tears Female Original Article Superior capsule reconstruction Range of motion business Joint Capsule |
| Zdroj: | Clinics in Orthopedic Surgery |
| ISSN: | 2005-4408 |
| Popis: | Backgroud Treatment remains a challenge in massive and irreparable rotator cuff tears (RCTs), and superior capsular reconstruction (SCR) has become an increasingly popular choice. The objective of this study was to evaluate clinical and radiological outcomes after SCR using an Achilles tendon allograft in irreparable massive RCTs. Methods From December 2015 to March 2018, 11 patients (mean age, 66.3 ± 5.8 years) with irreparable massive RCTs who underwent SCR using an Achilles tendon allograft were enrolled in this study. The range of motion (ROM), visual analog scale (VAS), clinical scores, muscle strength, and acromiohumeral distance (AHD) were measured preoperatively and at 3, 6, and 12 months, and final follow-up postoperatively. Magnetic resonance imaging (MRI) was performed preoperatively and at 6 months postoperatively to assess the global fatty degeneration index and graft failure. Ultrasonography was also conducted preoperatively and at 3, 6, and 12 months, and final follow-up postoperatively to assess graft continuity. Results The mean follow-up period was 27.6 months (range, 24-32 months). The shoulder ROM at final follow-up increased significantly in forward flexion (p = 0.023), external rotation (p = 0.018), internal rotation (p = 0.016), and abduction (p = 0.011). All patients showed improvement in VAS score (p = 0.005) and clinical scores (p < 0.001) compared with the preoperative state. Pseudoparalysis improved in all patients. The AHD was 3.88 mm (± 1.21 mm) preoperatively, 7.75 mm (± 1.52 mm, p = 0.014) at 6 months postoperatively, and 6.37 mm (± 1.72 mm, p = 0.031) at final follow-up. Graft removal and synovectomy were performed in 1 patient who developed postoperative infections. Radiological failure on follow-up MRI occurred in 2 patients at 6 and 12 months postoperatively, respectively. Conclusions SCR using an Achilles tendon allograft in irreparable massive RCTs achieved functional and clinical improvement. The use of Achilles tendon allograft also has the advantages of short operation time without donor site morbidity, sufficient thickness, and robustness; therefore, this allograft can be a useful graft for SCR. |
| Databáze: | OpenAIRE |
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