HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 34/3/392    most recent 0363546505281237v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Moore, D. R. Articles by Clancy, W. G. Search for Related Content PubMed PubMed Citation Articles by Moore, D. R. Articles by Clancy, W. G., Jr Related Collections Imaging Studies Shoulder Operative

Allograft Reconstruction for Massive, Irreparable Rotator Cuff Tears

David R. Moore, MD^*,, E. Lyle Cain, MD, Martin L. Schwartz, MD and William G. Clancy, Jr, MD^||

From Southern Sports Medicine, Nashville, Tennessee, the Alabama Sports Medicine and Orthopaedic Center, Birmingham, Alabama, the American Sports Medicine Institute, Birmingham, Alabama, and ^|| Orthopaedic Associates of Aspen and Glenwood, Aspen, Colorado

^* Address correspondence to David R. Moore, MD, 2021 Church Street, Suite 200, Nashville, TN 37203 (e-mail: dmoore{at}southernsportsmed.com).

Background: There is currently no widely accepted treatment for massive, irreparable rotator cuff tears.

Hypothesis: Allograft reconstruction to span the remaining defect in massive, irreparable rotator cuff tears will lead to increased functional results and will demonstrate healing of the allograft on follow-up magnetic resonance imaging studies.

Study Design: Case series; Level of evidence, 4.

Methods: Between 1989 and 2003, 32 patients underwent allograft reconstruction of massive rotator cuff tears. University of California, Los Angeles shoulder scores were compared preoperatively and postoperatively and analyzed using paired Student t tests. In addition, 15 patients underwent postoperative magnetic resonance imaging to evaluate the structural integrity of the allograft reconstruction at the greater tuberosity insertion.

Results: Of 32 patients, 28 were available for review at a mean follow-up of 31.3 months; 23 of the 28 patients were satisfied with their outcome. There was 1 postoperative infection and 1 acute allograft rejection. The mean University of California, Los Angeles score increased from 12.1 preoperatively to 26.1 postoperatively (P < .001). All 15 patients evaluated with postoperative magnetic resonance imaging arthrograms demonstrated complete radiographic failure of the allograft rotator cuff reconstruction. Despite radiographic failure, the mean University of California, Los Angeles score increased from 13.2 preoperatively to 28.3 postoperatively in this subset of patients.

Conclusion: The functional results of this reconstruction method are similar to those reported for debridement and subacromial decompression alone and are satisfactory, despite magnetic resonance imaging arthrogram evaluation demonstrating failure of the structural integrity of the allograft. Allograft reconstruction carries increased risk of infection and rejection and is technically more difficult than other less expensive treatment options with similar functional results. Therefore, we do not recommend allograft reconstruction of massive and otherwise irreparable rotator cuff tears.

Key Words: allograft reconstruction • rotator cuff tear

This article has been cited by other articles:

				C. Gerber, S. D. Pennington, E. J. Lingenfelter, and A. Sukthankar Reverse Delta-III Total Shoulder Replacement Combined with Latissimus Dorsi Transfer. A Preliminary Report J. Bone Joint Surg. Am., May 1, 2007; 89(5): 940 - 947. [Abstract] [Full Text] [PDF]