Clin Orthop Surg.  2014 Sep;6(3):329-335. 10.4055/cios.2014.6.3.329.

Mini-Open Suture Bridge Repair with Porcine Dermal Patch Augmentation for Massive Rotator Cuff Tear: Surgical Technique and Preliminary Results

• Cho CH
• Lee SM
• Lee YK
• Shin HK

• KMID: 1794716
• DOI: http://doi.org/10.4055/cios.2014.6.3.329

Abstract

BACKGROUND
The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results.
METHODS
Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively.
RESULTS
The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient.
CONCLUSIONS
Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint.

Keyword

Rotator cuff; Massive tear; Porcine dermal patch; Mini-open; Suture bridge techniquetear

MeSH Terms

Biocompatible Materials
*Collagen
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Prostheses and Implants
Rotator Cuff/injuries/pathology/*surgery
Suture Techniques
Tendon Injuries/diagnosis/*surgery
Biocompatible Materials
Collagen

Figure

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  Fig. 1 Schematic illustrations of the mini-open suture bridge technique with porcine dermal patch augmentation. (A) Medialization of the footprint and medial row fixation using suture anchors. (B) Suture bridge fixation and marginal sutures with porcine dermal patch augmentation.

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  Fig. 2 Preoperative (A) and postoperative (B) magnetic resonance images. The image obtained 6 months after surgery shows an intact repair with graft incorporation.

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  Fig. 3 Preoperative (A) and postoperative (B, C) magnetic resonance images. Images obtained 8 months after surgery show a full-thickness re-tear of the repaired supraspinatus (B) but with partial healing of the posterior edge of the rotator cuff and graft incorporation (C).

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