No Difference In Clinical Outcomes Following Repair of Large Retracted Anterior Rotator Cuff Tears Using Patch Augmentation With Human Dermal Allograft Versus Anterior Cable Reconstruction With Biceps Tendon Autograft

Abstracts

Purpose

The purpose of this study was to compare the clinical outcomes and tendon integrity after rotator cuff repair combined with anterior cable reconstruction (ACR) using the proximal biceps tendon and patch augmentation (PA) using a human dermal allograft (HDA) in a large retracted anterior rotator cuff tear.

Methods

Patients who underwent arthroscopic rotator cuff repair with two different augmentation procedures between January 2017 and December 2020 were enrolled. The inclusion criteria were patients who were treated by arthroscopic rotator cuff repair with ACR using the proximal biceps tendon (ACR group) or patch augmentation using a HDA (PA group) and follow-up for at least 2 years. Clinical outcomes were assessed using ASES score, Constant score and the number of patients who achieved minimal clinically important differences (MCID).. MRI was performed to evaluate tendon integrity postoperatively.

Results

A total of 92 patients were enrolled (ACR group; 55 patients and PA group; 37 patients). The mean ASES and Constant scores significantly improved in the ACR group (68.8 ± 15.3 and 58.4 ± 16.9 preoperatively vs 91.4 ± 6.3 and 87.8 ± 6.0 postoperatively, p < .001) and in the PA group (63.7 ± 16.7 and 57.9 ± 15.4 preoperatively vs 93.1 ± 6.3 and 88.3 ± 6.2 postoperatively, p < .001). Overall, 78 patients (84.8%) achieved the MCID with 81.8% in ACR group, 89.2% in PA group with no significant differences between the two groups (p = .638). Ten patients (18.2%) had retear in the ACR group and, three patients (8.1%) had retear in the PA group (p = .174).

Conclusions

In large retracted anterior rotator cuff tears, both augmentation techniques using biceps tendon autograft and HDA provided satisfactory clinical outcomes achieved the MCID in 84.8%, ROM restoration and lower retear rates with no significant differences between the two groups.