Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results

Arthroscopy. 2008 Apr;24(4):403-409.e1. doi: 10.1016/j.arthro.2007.07.033.

Abstract

Purpose: Our purpose was to assess the short-term results and describe the technique of arthroscopic repair of irreparable rotator cuff tears by use of a GraftJacket allograft (Wright Medical Technology, Arlington, TN).

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 up for 1 to 2 years. All were evaluated preoperatively and postoperatively by use of the modified University of California, Los Angeles scoring system, Constant score, and Simple Shoulder Test. Magnetic resonance imaging was performed postoperatively at 3 months and 1 year.

Results: At a mean follow-up of 26.8 months (range, 12 to 38 months), 15 of 16 patients were satisfied with the procedure. The mean University of California, Los Angeles score increased from 18.4 preoperatively to 30.4 postoperatively (P = .0001). The Constant score increased from 53.8 to 84.0 (P = .0001). Statistically significant improvements were seen in pain, forward flexion, and external rotation strength. Thirteen patients had 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. This treatment option may provide patients with decreased pain and increased function despite a previously irreparable rotator cuff tear.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Adult
  • Aged
  • Arthroscopy / methods*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Care
  • Preoperative Care
  • Probability
  • Reconstructive Surgical Procedures / methods*
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries*
  • Shoulder Joint / injuries
  • Shoulder Joint / surgery
  • Tendon Injuries / diagnosis
  • Tendon Injuries / surgery
  • Time Factors
  • Tissue and Organ Harvesting
  • Transplantation, Homologous
  • Treatment Outcome