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 Arthroscopic total rotator cuff replacement with an acellular human dermal allograft matrix

Ryan Dopirak1, James L Bond2, Stephen J Snyder3
1 Department of Arthroscopic Shoulder Surgery and Sports Medicine, Lakeshore Orthopedics, 1650 S. 41st Street, Manitowoc, WI 54221, USA
2 Orthopedic Surgery and Sports Medicine, Oklahoma Sports and Orthopedic Institute, 4212 Waterfront Circle, Norman, OK 73072, USA
3 Arthroscopic Shoulder Surgery, Southern California Orthopedic Institute, 6815 Noble Avenue, Van Nuys, CA 91405, USA

Correspondence Address:
Ryan Dopirak
1650 S. 41st Street, Manitowoc
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.30673

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Year : 2007  |  Volume : 1  |  Issue : 1  |  Page : 7-15

 
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Purpose: To describe the technique and short-term results of arthroscopic repair of irreparable rotator cuff tears using a GraftJacket® allograft. Although current rotator cuff repair techniques offer excellent results in most cases, there are still many instances where tendon repair is not possible. Allograft substitutes offer the advantages of saving bone stock, while maintaining anatomic integrity within the shoulder. Materials and Methods: Between March 2003 and February 2004, 16 patients with massive, contracted immobile rotator cuff tears were treated with arthroscopic placement of a GraftJacket® allograft by a single surgeon. Patients were followed for 1-2 years. All were evaluated preoperatively and postoperatively using the modified University of California Los Angeles (UCLA) scoring system, Constant score and Simple Shoulder Test. MRI was performed postoperatively at 3 months and 1 year. Results: At mean follow-up time of 26.8 months (range, 12-38 months), 15 of 16 patients were satisfied with the procedure. The mean UCLA score increased from 18.4 preoperatively to 30.4 postoperatively ( P = 0.0001). The Constant score increased from 53.8 to 84.0 ( P = 0.0001). Statistically significant improvements were seen in pain, forward flexion and external rotation strength. Thirteen displayed full incorporation of the graft into the native tissue, as documented on magnetic resonance imaging. There were no complications in this cohort of patients. Conclusions: Our study supports GraftJacket® allograft as a viable solution for surgical salvage in select cases of massive irreparable rotator cuff pathology.






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 ORIGINAL ARTICLE
 



Ryan Dopirak1, James L Bond2, Stephen J Snyder3
1 Department of Arthroscopic Shoulder Surgery and Sports Medicine, Lakeshore Orthopedics, 1650 S. 41st Street, Manitowoc, WI 54221, USA
2 Orthopedic Surgery and Sports Medicine, Oklahoma Sports and Orthopedic Institute, 4212 Waterfront Circle, Norman, OK 73072, USA
3 Arthroscopic Shoulder Surgery, Southern California Orthopedic Institute, 6815 Noble Avenue, Van Nuys, CA 91405, USA

Correspondence Address:
Ryan Dopirak
1650 S. 41st Street, Manitowoc
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.30673

Rights and Permissions

Purpose: To describe the technique and short-term results of arthroscopic repair of irreparable rotator cuff tears using a GraftJacket® allograft. Although current rotator cuff repair techniques offer excellent results in most cases, there are still many instances where tendon repair is not possible. Allograft substitutes offer the advantages of saving bone stock, while maintaining anatomic integrity within the shoulder. Materials and Methods: Between March 2003 and February 2004, 16 patients with massive, contracted immobile rotator cuff tears were treated with arthroscopic placement of a GraftJacket® allograft by a single surgeon. Patients were followed for 1-2 years. All were evaluated preoperatively and postoperatively using the modified University of California Los Angeles (UCLA) scoring system, Constant score and Simple Shoulder Test. MRI was performed postoperatively at 3 months and 1 year. Results: At mean follow-up time of 26.8 months (range, 12-38 months), 15 of 16 patients were satisfied with the procedure. The mean UCLA score increased from 18.4 preoperatively to 30.4 postoperatively ( P = 0.0001). The Constant score increased from 53.8 to 84.0 ( P = 0.0001). Statistically significant improvements were seen in pain, forward flexion and external rotation strength. Thirteen displayed full incorporation of the graft into the native tissue, as documented on magnetic resonance imaging. There were no complications in this cohort of patients. Conclusions: Our study supports GraftJacket® allograft as a viable solution for surgical salvage in select cases of massive irreparable rotator cuff pathology.






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© 2006 - International Journal of Shoulder Surgery
| Published by Wolters Kluwer - Medknow Online since 1st September '06