Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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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

  • Hyun-Gyu Seok (Department of Orthopedic Surgery, Yeungnam University Medical Center) ;
  • Sam-Guk Park (Department of Orthopedic Surgery, Yeungnam University Medical Center)
  • Received : 2022.12.20
  • Accepted : 2023.04.15
  • Published : 2023.12.01
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Abstract

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.

Keywords

Acknowledgement

The authors would specially thank Jung kyoung Yoon, who works as a musculoskeletal radiologist at Nazareth General Hospital, for her assistance in the radiologic examination.

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