title: Treatment of massive rotator-cuff tears with a polyester ligament (LARS) patch.
abstract: We describe and analyse the results of our technique for repairing chronic massive tears (Goutallier grade 3 or 4) of the rotator cuff using a ligament augmentation and reconstruction system. This prospective, single surgeon series included 29 symptomatic patients (21 male, 8 female) with a mean age of 67.1 years who underwent 31 ligament augmentation and reconstruction system procedures (two bilateral procedures) with a mean follow-up period of 3 years. All patients had clinical, radiographic, magnetic resonance imaging and arthroscopic evidence of a chronic massive rotator cuff tear. The primary outcome measure was assessed using the Oxford Shoulder Score and visual analogue score pre-operatively and at follow-up. Postoperative overall Oxford shoulder score and visual analogue score results demonstrated a statistically significant improvement at follow-up, compared with pre-operative values (p < 0.0001). Post-operative acromio-humeral interval showed a statistically significant increase when compared to pre-operative radiographs (p = 0.0004). Two patients required revision with good postoperative results. We believe that, in the appropriate age group, the ligament augmentation and reconstruction system repair offers a good option for chronic, primary, non-closable rotator cuff defects in terms of pain relief and function.
authors.affiliation: Department of Orthopaedic Surgery, Barnsley Hospital NHS Foundation Trust, Gawber Road, Barnsley, South Yorkshire S75 2EP, UK. Mike.petrie@doctors.org.uk
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Petrie
authors.affiliation: Barnsley Hospital NHS Foundation Trust, Barnsley, South Yorkshire, UK.
authors.forename: A Hany
authors.initials: AH
authors.lastname: Ismaiel
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011091:Polyesters; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods; D017006:Rotator Cuff / Q000503:physiopathology; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012782:Shoulder / Q000503:physiopathology; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D011091:Polyesters