Augmenting double-row arthroscopic rotator cuff repair with dermal allograft leads to improved functional outcomes after complex and revision rotator cuff tears, a new study finds.
“Primary rotator cuff repairs in complex cases (older patient age, larger tear sizes, chronic tears) and revision repairs are at high risk for failure of healing,” the researchers wrote.
The study, “Healing and Functional Results of Dermal Allograft Augmentation Of Complex and Revision Rotator Cuff Repairs,” was published online on May 20, 2021 in The American Journal of Sports Medicine.
For this study, the research team sought to better understand the clinical outcomes and healing rates in complex and revision rotator cuff repairs with dermal allograft augmentation.
The retrospective study included 35 cases performed by 3 fellowship-trained surgeons who all used the same double-row technique with allograft augmentation. There were 23 revision repairs and 12 primary complex repairs.
The mean age of the patients was 57.9 years. All the shoulders had 2-tendon tears and 8 included the upper half of the subscapularis.
For each patient, a 1.5mm, human, decellularized dermal graft was tied on top of the tendon at the medial row and compressed to the rotator cuff footprint.
Postoperative magnetic resonance imaging results at 6 months and American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and 12-Item Short Form Health Survey scores at a minimum of 2 years after surgery were also collected.
At follow-up, the mean ASES and SANE scores improved from 42.4 and 35.3 to 77.6 and 73.5, respectively (p < .001).
In the 23 patients for which postoperative MRI evaluation was possible, 11 had images showing a retear. The researchers also found that ASES (89.7 vs. 66.4; p = .04) and SANE (84.1 vs. 50.5; p = .02) scores were higher in those patients who fully healed than those with retears.
The retear group also had more preoperative fatty atrophy of the infraspinatus (p = .024).
“Double-row arthroscopic repair with dermal allograft augmentation of complex and revision rotator cuff tears led to improved functional outcomes. Approximately half of patients experienced a failure of healing, which was associated with poorer functional results,” the researchers wrote.
