Vol 9 | Issue 1 | January-June 2023 | page: 01-04 | Florian Hess, JoEllen Welter, Laurenz Jaberg
Authors: Florian Hess , JoEllen Welter , Laurenz Jaberg 
 Department of Orthopaedic Surgery and Traumatology, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.
 Department of Orthopaedic Surgery, Clinica Ars Medica, Gravesano, Switzerland.
Address of Correspondence
Dr. Florian Hess,
Department of Orthopaedic Surgery and Traumatology Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.
Background: Treatment of massive rotator cuff (RC) tears can result in re-rupture rates up to 94%, and some studies have detected re-ruptures occurring 3.5 years postoperatively. This study aimed to compare long-term clinical outcomes, measured at two time points, after massive RC tears with patch augmentation.
Methods: We performed 58 arthroscopic RC reconstructions augmented with a synthetic polyester patch between 2012 and 2014. 50 patients were available for long-term follow-up one and five years after surgery. We compared clinical outcomes (Constant-Murley score (CS) and subjective shoulder value (SSV)) to assess if the results were sustained over time.
Results: 86% (50/58) of the patients were assessed at the one- and five-year follow-up visits. The median CS one year postoperative reached 84 (interquartile range 76.5-90), and SSV was 95 (IQR 82.5-100). The median CS five years after surgery was 85 (IQR 81.5-91.5) and SSV was 95 (IQR 85-100). The clinical improvement between postoperative years one and five was statistically significant for CS (p=0.0013) and SSV (p<0.0001).
Conclusions: Rotator cuff repair with polyester patch augmentation achieved good clinical outcomes over the long term. Clinical improvement continued over time, with slightly more favorable results measured at the five-year follow-up visits.
Keywords: Massive rotator cuff tears, Augmentation, Patch, Shoulder, Arthroscopy
1. Tan M, Lam PH, Le BT, Murrell GA (2016) Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 25 (1):12-21.
2. Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL (2012) National trends in rotator cuff repair. J Bone Joint Surg [Am] 94 (3):227-233.
3. Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN (2014) Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskelet Disord 15:4.
4. Paloneva J, Lepola V, Aarimaa V, Joukainen A, Ylinen J, Mattila VM (2015) Increasing incidence of rotator cuff repairs–A nationwide registry study in Finland. BMC Musculoskelet Disord 16:189.
5. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res (304):78-83.
6. Davey MS, Hurley ET, Carroll PJ, Galbraith JG, Shannon F, Kaar K, Mullett H (2023) Arthroscopic Rotator Cuff Repair Results in Improved Clinical Outcomes and Low Revision Rates at 10-Year Follow-Up: A Systematic Review. Arthrosc – J Arthrosc Relat Surg 39 (2):452-458.
7. Meyer DC, Wieser K, Farshad M, Gerber C (2012) Retraction of supraspinatus muscle and tendon as predictors of success of rotator cuff repair. Am J Sports Med. 40 (10):2242-2247.
8. Shah NS, Suriel Peguero E, Umeda Y, Crawford ZT, Grawe BM (2022) Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review. HSS J 18 (1):130-137.
9. Smolen D, Haffner N, Mittermayr R, Hess F, Sternberg C, Leuzinger J (2020) Application of a new polyester patch in arthroscopic massive rotator cuff repair-a prospective cohort study. J Shoulder Elbow Surg 29 (1):e11-e21.
10. Proctor CS (2014) Long-term successful arthroscopic repair of large and massive rotator cuff tears with a functional and degradable reinforcement device. J Shoulder Elbow Surg 23 (10):1508-1513.
11. Gerber C, Fuchs B, Hodler J (2000) The results of repair of massive tears of the rotator cuff. J Bone Joint Surg [Am] 82 (4):505-515.
12. Davidson J, Burkhart SS (2010) The geometric classification of rotator cuff tears: a system linking tear pattern to treatment and prognosis. Arthrosc – J Arthrosc Relat Surg 26 (3):417-424.
13. Bailey JR, Kim C, Alentorn-Geli E, Kirkendall DT, Ledbetter L, Taylor DC, Toth AP, Garrigues GE (2019) Rotator Cuff Matrix Augmentation and Interposition: A Systematic Review and Meta-analysis. Am J Sports Med 47 (6):1496-1506.
14. Ferguson DP, Lewington MR, Smith TD, Wong IH (2016) Graft Utilization in the Augmentation of Large-to-Massive Rotator Cuff Repairs: A Systematic Review. Am J Sports Med 44 (11):2984-2992.
15. Steinhaus ME, Makhni EC, Cole BJ, Romeo AA, Verma NN (2016) Outcomes After Patch Use in Rotator Cuff Repair. Arthroscopy 32 (8):1676-1690.
16. Smolen D, Haffner N, Mittermayr R, Hess F, Sternberg C, Leuzinger J (2019) Application of a new polyester patch in arthroscopic massive rotator cuff repair-a prospective cohort study. J Shoulder Elbow Surg.
17. Barber FA, Burns JP, Deutsch A, Labbe MR, Litchfield RB (2012) A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthrosc – J Arthrosc Relat Surg 28 (1):8-15.
18. Gilot GJ, Alvarez-Pinzon AM, Barcksdale L, Westerdahl D, Krill M, Peck E (2015) Outcome of Large to Massive Rotator Cuff Tears Repaired With and Without Extracellular Matrix Augmentation: A Prospective Comparative Study. Arthroscopy 31 (8):1459-1465.
19. Mori D, Funakoshi N, Yamashita F (2013) Arthroscopic surgery of irreparable large or massive rotator cuff tears with low-grade fatty degeneration of the infraspinatus: patch autograft procedure versus partial repair procedure. Arthroscopy 29 (12):1911-1921.
20. Audenaert E, Van Nuffel J, Schepens A, Verhelst M, Verdonk R (2006) Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 14 (4):360-364.
21. Badhe SP, Lawrence TM, Smith FD, Lunn PG (2008) An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears. J Shoulder Elbow Surg 17 (1 Suppl):35S-39S.
22. Giannotti S, Ghilardi M, Dell’osso G, Magistrelli L, Bugelli G, Di Rollo F, Ricci G, Calabrese R, Siciliano G, Guido G (2014) Study of the porcine dermal collagen repair patch in morpho-functional recovery of the rotator cuff after minimum follow-up of 2.5 years. Surg Technol Int 24:348-352.
23. Nada AN, Debnath UK, Robinson DA, Jordan C (2010) Treatment of massive rotator-cuff tears with a polyester ligament (Dacron) augmentation: clinical outcome. J Bone Joint Surg Br 92 (10):1397-1402.
24. Rotini R, Marinelli A, Guerra E, Bettelli G, Castagna A, Fini M, Bondioli E, Busacca M (2011) Human dermal matrix scaffold augmentation for large and massive rotator cuff repairs: preliminary clinical and MRI results at 1-year follow-up. Musculoskelet Surg 95 Suppl 1:S13-23.
25. Ciampi P, Scotti C, Nonis A, Vitali M, Di Serio C, Peretti GM, Fraschini G (2014) The benefit of synthetic versus biological patch augmentation in the repair of posterosuperior massive rotator cuff tears: a 3-year follow-up study. Am J Sports Med 42 (5):1169-1175.
26. Longo UG, Lamberti A, Maffulli N, Denaro V (2010) Tendon augmentation grafts: a systematic review. Br Med Bull 94:165-188.
27. Iannotti JP, Codsi MJ, Kwon YW, Derwin K, Ciccone J, Brems JJ (2006) Porcine small intestine submucosa augmentation of surgical repair of chronic two-tendon rotator cuff tears. A randomized, controlled trial. J Bone Joint Surg [Am] 88 (6):1238-1244.
28. Papalia R, Franceschi F, Zampogna B, D’Adamio S, Maffulli N, Denaro V (2013) Augmentation techniques for rotator cuff repair. Br Med Bull 105:107-138.
29. Phipatanakul WP, Petersen SA (2009) Porcine small intestine submucosa xenograft augmentation in repair of massive rotator cuff tears. Am J Orthop 38 (11):572-575.
30. Sclamberg SG, Tibone JE, Itamura JM, Kasraeian S (2004) Six-month magnetic resonance imaging follow-up of large and massive rotator cuff repairs reinforced with porcine small intestinal submucosa. J Shoulder Elbow Surg 13 (5):538-541.
31. Walton JR, Bowman NK, Khatib Y, Linklater J, Murrell GA (2007) Restore orthobiologic implant: not recommended for augmentation of rotator cuff repairs. J Bone Joint Surg [Am] 89 (4):786-791.
32. Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, Schemitsch E (2015) Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review. Arthroscopy 31 (12):2472-2480.
33. Shimokobe H, Gotoh M, Honda H, Nakamura H, Mitsui Y, Kakuma T, Okawa T, Shiba N (2017) Risk factors for retear of large/massive rotator cuff tears after arthroscopic surgery: an analysis of tearing patterns. J Orthop Surg Res 12 (1):140.
34. Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA, Hughes RE, Carpenter JE (2011) When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39 (10):2064-2070.
|How to Cite this article: Hess F, Welter J, Jaberg L | Long-term Outcomes Following Synthetic Patch Augmentation to Treat Rotator Cuff Tears | January-June 2023; 9(1): 01-04 | https://doi.org/10.13107/ti.2023.v09i01.031|