Purpose: To report the results of the arthroscopic superior capsule reconstruction (ASCR) technique with a combined fascia lata autograft and synthetic scaffold patch graft for irreparable massive rotator cuff tears (RCTs).
Methods: The period for this retrospective study was between December 2016 and December 2020. The criteria for inclusion were patients treated arthroscopically for an incompletely repaired massive RCT (dimension >5 cm and 2 tendons fully torn, intact or reparable subscapularis tendons and teres minor tendon with or without irreparable infraspinatus, a radiological Hamada classification between grade 0 and 4, and a minimum 24-month postoperative follow-up). Clinical outcomes were evaluated preoperatively and at a final follow-up by a visual analog scale (VAS) for pain and range of motion along with the American Shoulder and Elbow Surgeons score (ASES), the University of California Los Angeles score (UCLA), and the Constant-Murley score (CMS). Radiological outcomes were assessed, according to the rotator cuff arthropathy (RCA) and the acromiohumeral distance (AHD) stages. Graft integrity and muscle fatty infiltration were evaluated by magnetic resonance imaging (MRI).
Results: A total of 43 patients were enrolled in the study with a mean follow-up duration of 45.6 months (range: 24 to 64). All clinical scores also improved at the 2-year follow-up (mean: VAS 0.7 [SD 0.7] vs 5.4 [SD 1.1]; P < .001; mean: ASES 92.6 [SD 8.0] vs 34.8 [SD 13.4]; P < .001; mean UCLA 31.5 [SD 3.9] vs 11.0 [SD 3.2]; P < .001; and mean CMS 86.6 [SD 7.2] vs 40.0 [SD 11.6]; P < .001), and 39 of 43 fascia lata grafts were fully intact on MRI (91%).
Conclusions: ASCR with a combined fascia lata autograft and synthetic scaffold patch graft resulted in good functional outcomes, with a high rate of graft healing at the 2-year follow-up. All patients achieved clinically relevant improvement (met minimal clinically important differences [MCID]) on ASES, UCLA, and VAS with improved abduction strength restoration.
Level Of Evidence: Level IV, retrospective case series.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arthro.2023.02.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optimizing skull base defect repair: leveraging the reused nasoseptal flap as a reliable material.
Eur Arch Otorhinolaryngol
January 2025
Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Purpose: The escalating number of endoscopic skull base procedures necessitates exploring additional materials to reduce postoperative cerebrospinal fluid (CSF) leaks in revision or staged surgeries. This study evaluates the effectiveness of reused nasoseptal flaps (NSFs) in such clinical scenarios.
Methods: A retrospective review was conducted on patients who previously underwent surgery involving NSFs and later had revision or secondary skull base surgeries via endoscopic endonasal approaches (EEAs) at a tertiary medical center.
A Case Report: Interposition Arthroplasty for Post-traumatic Elbow Arthritis.
J Orthop Case Rep
January 2025
Department of Orthopaedics, Dr. KNS Memorial Institute of Medical Sciences, Barabanki, Uttar Pradesh, India.
Introduction: Post-traumatic arthritis of elbow is a crippling condition that frequently develops after a serious joint injury. The condition is characterized by pain, rigidity, and diminished functionality, considerably affecting the quality of life of those impacted. Despite advancements in surgical and conservative management, the optimal treatment strategy remains elusive.
View Article and Find Full Text PDFArthroscopic-Assisted Lower Trapezius Tendon Transfer With Fascia Lata Autograft for Irreparable Posterior-Superior Rotator Cuff Tears.
Arthrosc Tech
December 2024
Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
Lower trapezius tendon transfer is a surgical procedure that has become increasingly popular in recent years. The biggest advantage of this method is that the pulling direction of the lower trapezius is the same as that of the infraspinatus. Thus, the transferred lower trapezius tendon can biomechanically mimic the functions of the posterior-superior rotator cuff.
View Article and Find Full Text PDFAssessing Physician Assistant Students' Ability to Accurately Identify the Regional Landmarks of the Fascia Iliaca Compartment With Point of Care Ultrasound After a Brief Training Session.
Mil Med
January 2025
Department of Emergency Medicine, Mike O'Callaghan Military Medical Center, Las Vegas Blvd, NV 89191, USA.
Introduction: Regional anesthesia, specifically fascia iliaca compartment blocks (FICB), is highly effective in managing pain, especially in military settings. However, a significant barrier to its implementation is the lack of provider confidence in performing ultrasound-guided procedures. This study evaluates the ability of physician assistant (PA) students, who are often first-line providers in austere locations, to identify the fascia iliaca compartment (FIC) using point-of-care ultrasound (POCUS) after a brief training session and assesses their retention of this skill over a 60- to 90-day period.
View Article and Find Full Text PDFIliac Crest Bone Graft and Fascia Lata Free Flap for Rescue of Mandibular Osteoradionecrosis.
Otolaryngol Head Neck Surg
January 2025
Section of Facial Plastic and Microvascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Objective: Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).
Study Design: Retrospective chart review.
Setting: Single institution.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!