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Interposition Graft Bridging Reconstruction of Irreparable Rotator Cuff Tears Using Acellular Dermal Matrix: Medium-Term Results

      Purpose

      In this study, we aimed to evaluate the medium-term clinical outcomes for patients who underwent bridging reconstruction.

      Methods

      A retrospective chart review was conducted for all patients who underwent bridging reconstruction between 2010 and 2018. Patients who were missing either pre- or postoperative outcome scores were excluded. All included patients completed self-reported questionnaires (Western Ontario Rotator Cuff [WORC] and Disabilities of the Arm, Shoulder and Hand [DASH]) pre- and postoperatively at 6 months, 1 year, and annually thereafter. All scores were reported out of 100.

      Results

      Ninety-one patients initially met our inclusion criteria, and 33 were excluded owing to lack of either pre- or postoperative outcome scores. Nine patients were lost to follow-up; therefore, 49 patients were finally evaluated, including 30 males (61.2%) and 19 females (38.8%) with an age of 59.6 ± 10.4 years (mean ± standard deviation) and mean follow-up of 5.3 years (range 2 to 9). Both WORC and DASH scores significantly improved from pre- to postoperatively (WORC: 69.6 ± 12.2 to 27.9 ± 23.7, P < .001; DASH: 51.5 ± 17.5 to 24.5 ± 23.0, P = .001). For WORC and DASH, 92% and 74% of patients, respectively, met the minimal clinical importance difference.

      Conclusion

      Our results showed that patients’ clinical outcome scores significantly improved with an average of 5-year follow-up, which demonstrates that bridging reconstruction is a safe procedure with promising midterm clinical outcomes.

      Level of Evidence

      IV, retrospective case series
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      References

        • Wong I.
        • Burns J.
        • Snyder S.
        Arthroscopic GraftJacket repair of rotator cuff tears.
        J Shoulder Elbow Surg. 2010; 19: 104-109
        • Lin J.
        • Sun Y.
        • Chen Q.
        • et al.
        Outcome comparison of graft bridging and superior capsule reconstruction for large to massive rotator cuff tears: a systematic review.
        Am J Sports Med. 2020; 48: 2828-2838
        • DeOrio J.K.
        • Cofield R.H.
        Results of a second attempt at surgical repair of a failed initial.
        J Bone Joint Surg Am. 1984; 66: 563-567
        • Wu X.L.
        • Briggs L.
        • Murrell G.A.C.
        Intraoperative determinants of rotator cuff repair integrity: an analysis of 500 consecutive repairs.
        Am J Sports Med. 2012; 40: 2771-2776
        • Lewington M.R.
        • Ferguson D.P.
        • Smith T.D.
        • et al.
        Graft utilization in the bridging reconstruction of irreparable rotator cuff tears: a systematic review.
        Am J Sports Med. 2017; 45: 3149-3157
        • Zingg P.O.
        • Jost B.
        • Sukthankar A.
        • et al.
        Clinical and structural outcomes of nonoperative management of massive rotator cuff tears.
        J Bone Joint Surg Am. 2007; 89: 1928-1934
        • Burkhart S.S.
        • Nottage W.M.
        • Ogilvie-Harris D.J.
        • et al.
        Partial repair of irreparable rotator cuff tears.
        Arthroscopy. 1994; 10: 363-370
        • Chen K.-H.
        • Chiang E.-R.
        • Wang H.-Y.
        • Ma H.-L.
        Arthroscopic partial repair of irreparable rotator cuff tears: factors related to greater degree of clinical improvement at 2 years of follow-up.
        Arthroscopy. 2017; 33: 1949-1955
        • Namdari S.
        • Voleti P.
        • Baldwin K.
        • et al.
        Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a systematic review.
        J Bone Joint Surg Am. 2012; 94: 891-898
        • Burnier M.
        • Elhassan B.T.
        • Sanchez-Sotelo J.
        Surgical management of irreparable rotator cuff tears: what works, what does not, and what is coming.
        J Bone Joint Surg Am. 2019; 101: 1603-1612
        • Neviaser J.S.
        • Neviaser R.J.
        • Neviaser T.J.
        The repair of chronic massive ruptures of the rotator cuff of the shoulder by use of a freeze-dried rotator cuff.
        J Bone Joint Surg Am. 1978; 60: 681-684
        • Angelo R.L.
        • Esch J.
        • Ryu R.K.
        Angelo RL Ryu R.K.N. Esch J. AANA Advanced Arthroscopy: The Shoulder E-Book. Elsevier Health Sciences, Amsterdam2010
        • Gulotta L.V.
        • Craig E.V.
        Gulotta L.V. Craig E.V. Massive Rotator Cuff Tears: Diagnosis and Management. Springer, New York2014
        • Bond J.L.
        • Dopirak R.M.
        • Higgins J.
        • et al.
        Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results.
        Arthroscopy. 2008; 24: 403-409
        • Gupta A.K.
        • Hug K.
        • Berkoff D.J.
        • et al.
        Dermal tissue allograft for the repair of massive irreparable rotator cuff tears.
        Am J Sports Med. 2012; 40: 141-147
        • Moore D.R.
        • Cain E.L.
        • Schwartz M.L.
        • Clancy Jr., W.G.
        Allograft reconstruction for massive, irreparable rotator cuff tears.
        Am J Sports Med. 2006; 34: 392-396
        • Barber F.A.
        • Burns J.P.
        • Deutsch A.
        • et al.
        A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair.
        Arthroscopy. 2012; 28: 8-15
        • Crapo P.M.
        • Gilbert T.W.
        • Badylak S.F.
        An overview of tissue and whole organ decellularization processes.
        Biomaterials. 2011; 32: 3233-3243
        • Longo U.G.
        • Lamberti A.
        • Maffulli N.
        • Denaro V.
        Tendon augmentation grafts: a systematic review.
        Br Med Bull. 2010; 94: 165-188
        • Snyder S.J.
        • Arnoczky S.P.
        • Bond J.L.
        • Dopirak R.
        Histologic evaluation of a biopsy specimen obtained 3 months after rotator cuff augmentation with GraftJacket Matrix.
        Arthroscopy. 2009; 25: 329-333
        • Huang H.
        • Grant J.A.
        • Miller B.S.
        • Mirza F.M.
        • Gagnier J.J.
        A systematic review of the psychometric properties of patient-reported outcome instruments for use in patients with rotator cuff disease.
        Am J Sports Med. 2015; 43: 2572-2582
        • Holtby R.
        • Razmjou H.
        Measurement properties of the Western Ontario rotator cuff outcome measure: a preliminary report.
        J Shoulder Elbow Surg. 2005; 14: 506-510
        • Raman J.
        • Macdermid J.C.
        Western Ontario rotator cuff index.
        J Physiother. 2012; 8: 201
        • Wright R.W.
        • Baumgarten K.M.
        Shoulder outcomes measures.
        J Am Acad Orthop Surg. 2010; 18: 436-444
        • Christie A.
        • Dagfinrud H.
        • Garratt A.M.
        • Osnes H.R.
        • Hagen K.B.
        Identification of shoulder-specific patient acceptable symptom state in patients with rheumatic diseases undergoing shoulder surgery.
        J Hand Ther. 2011; 24: 53-61
        • Buford Jr., D.
        • Snyder S.J.
        Diagnostic shoulder arthroscopy: the 23-point arthroscopic evaluation with normal anatomical variants and pathology.
        in: Imhoff A.B. Ticker J.B. Fu F.H. An Atlas of Shoulder Arthroscopy. Martin Dunitz Publishers, London2003: 82-91
        • Dimitrios V.
        • Papaspiliopoulos A.
        • Antipa E.
        • Papacharalampous X.
        • Flevarakis G.
        • Feroussis J.
        Results of reconstruction of massive irreparable rotator cuff tears using a fascia lata allograft.
        Ind J Orthop. 2015; 49: 304-311
        • Neumann J.A.
        • Zgonis M.H.
        • Rickert K.D.
        • et al.
        Interposition dermal matrix xenografts: a successful alternative to traditional treatment of massive rotator cuff tears.
        Am J Sports Med. 2017; 45: 1261-1268
        • Gupta A.K.
        • Hug K.
        • Boggess B.
        • Gavigan M.
        • Toth A.P.
        Massive or 2-tendon rotator cuff tears in active patients with minimal glenohumeral arthritis: clinical and radiographic outcomes of reconstruction using dermal tissue matrix xenograft.
        Am J Sports Med. 2013; 41: 872-879
        • Badhe S.P.
        • Lawrence T.M.
        • Smith F.D.
        • Lunn P.G.
        An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears.
        J Shoulder Elbow Surg. 2008; 17: 35S-39S
        • Mori D.
        • Funakoshi N.
        • Yamashita F.
        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. 2013; 29: 1911-1921
        • Nada A.
        • Debnath U.K.
        • Robinson D.A.
        • Jordan C.
        Treatment of massive rotator-cuff tears with a polyester ligament (Dacron) augmentation: clinical outcome.
        J Bone Joint Surg Br. 2010; 92: 1397-1402
        • Audenaert E.
        • Van Nuffel J.
        • Schepens A.
        • Verhelst M.
        • Verdonk R.
        Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients.
        Knee Surg Sports Traumatol Arthosc. 2006; 14: 360-364
        • Seker V.
        • Hackett L.
        • Lam P.H.
        • Murrell G.A.C.
        Evaluating the outcomes of rotator cuff repairs with polytetrafluoroethylene patches for massive and irreparable rotator cuff tears with a minimum 2-year follow-up.
        Am J Sports Med. 2018; 46: 3155-3164
        • Shon M.S.
        • Koh K.H.
        • Lim T.K.
        • et al.
        Arthroscopic partial repair of irreparable rotator cuff tears: preoperative factors associated with outcome deterioration over 2 years.
        Am J Sports Med. 2015; 43: 1965-1975
        • Cuff D.J.
        • Pupello D.R.
        • Santoni B.G.
        Partial rotator cuff repair and biceps tenotomy for the treatment of patients with massive cuff tears and retained overhead elevation: midterm outcomes with a minimum 5 years of follow-up.
        J Shoulder Elbow Surg. 2016; 25: 1803-1809
        • Jones C.R.
        • Snyder S.J.
        Massive irreparable rotator cuff tears: a solution that bridges the gap.
        Sports Med Arthrosc Rev. 2015; 23: 130-138
        • Mihata T.
        • Lee T.Q.
        • Watanabe C.
        • et al.
        Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears.
        Arthroscopy. 2013; 29: 459-470
        • Denard P.J.
        • Brady P.C.
        • Adams C.R.
        • Tokish J.M.
        • Burkhart S.S.
        Preliminary results of arthroscopic superior capsule reconstruction with dermal allograft.
        Arthroscopy. 2018; 34: 93-99
        • Burkhart S.S.
        • Pranckun J.J.
        • Hartzler R.U.
        Superior capsular reconstruction for the operatively irreparable rotator cuff tear: clinical outcomes are maintained 2 years after surgery.
        Arthroscopy. 2020; 36: 373-380
        • Andersen W.J.
        • Panero A.A.J.
        Superior capsular reconstruction: clinical outcomes after minimum 2-year follow-up.
        Am J Orthop. 2017; 46: 266-272
        • Lee S.-J.
        • Min Y.-K.
        Can inadequate acromiohumeral distance improvement and poor posterior remnant tissue be the predictive factors of re-tear? Preliminary outcomes of arthroscopic superior capsular reconstruction.
        Knee Surg Sports Traumatol Arthosc. 2018; 26: 2205-2213
        • Hartzler R.U.
        • Steen B.M.
        • Hussey M.M.
        • et al.
        Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement.
        J Shoulder Elbow Surg. 2015; 24: 1698-1706
        • Ernstbrunner L.
        • Suter A.
        • Catanzaro S.
        • Rahm S.
        • Gerber C.
        Reverse total shoulder arthroplasty for massive, irreparable rotator cuff tears before the age of 60 years: long-term results.
        J Bone Joint Surg Am. 2017; 99: 1721-1729
        • Black E.M.
        • Roberts S.M.
        • Siegel E.
        • et al.
        Failure after reverse total shoulder arthroplasty: what is the success of component revision?.
        J Shoulder Elbow Surg. 2015; 24: 1908-1914