title: Successful early mobilization of major cuff repair using a suture post.
abstract: Repair of massive rotator cuff tears in the elderly can be challenging because of degenerative, retracted, and contracted tendons producing an extensive defect. The quality of the tendon and particularly the bone of the proximal humerus is an inherent weakness in the repaired construct. We report a method that secures the rotator cuff to a fixation post placed in cortical bone at the surgical neck of the humerus, bypassing the weakest point. This is an evolution of techniques designed to fix to the greater tuberosity. We reviewed 32 repairs (16 men and 14 women; mean age, 68 years) with a minimum of 2 years' follow-up (mean, 4.3 years). Constant scores improved from a mean of 27.9 preoperatively to 78.2 postoperatively. Pain scores improved from 8.2 to 1.9, with 87% of patients being satisfied with the results of surgery. This is a robust construct that is easily learned and able to solve a technical problem.
authors.affiliation: Modbury Public Hospital, Adelaide, South Australia. wattle135@ozemail.com.au
authors.forename: Robert N
authors.initials: RN
authors.lastname: Atkinson
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Comley
authors.forename: John
authors.initials: J
authors.lastname: Van Essen
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hallam
authors.forename: Neil
authors.initials: N
authors.lastname: Ashwood
authors.forename: Quentin A
authors.initials: QA
authors.lastname: Fogg
mesh_terms: D000174:Acromion / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D001863:Bone Screws; D002102:Cadaver; D004434:Early Ambulation; D005260:Female; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D013708:Tendon Injuries / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors