title: Human dermal allograft for massive rotator cuff tears.
abstract: Previously published studies reported variable results using various suture techniques and reconstruction options for massive rotator cuff tears. Therefore, the current authors retrospectively studied 21 consecutive patients/shoulders with massive rotator cuff tears treated from January 2005 to October 2011 with a human dermal allograft through a mini-open approach. Mean patient age was 58 years (range, 33-72 years). Mean follow-up was 29 months (range, 18-52 months). Ten patients underwent revision repair for a failed rotator cuff repair. The authors measured the tendon gap (mean, 1.7 cm) and acromiohumeral interval (mean, 6.5 mm). They evaluated pain, shoulder range of motion (ROM) and function, patient satisfaction with the operation and outcome, and complications. At last follow-up, all patients experienced significant pain relief (P=.001) and improved ROM (P=.001) and American Shoulder and Elbow Surgeons (ASES) score (P=.001). Eighteen patients reported that they were satisfied or very satisfied and 3 reported that they were not satisfied with the operation and outcome. Comparison of outcomes between patients who underwent primary repair and those who underwent revision repair and between patients who had muscle atrophy and fatty infiltration grades 0 to II and those who had grades III to IV showed no statistically significant differences. A statistically significant correlation was observed between the size of the tendon gap and postoperative pain, ROM (except external rotation), and ASES score (P<.050). No significant correlation was observed between postoperative pain, ROM, and ASES score and the acromiohumeral interval (P>.050). Complications related to the dermal human allograft were not observed.
authors.forename: Zinon T
authors.initials: ZT
authors.lastname: Kokkalis
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: Marius
authors.initials: M
authors.lastname: Scarlat
authors.forename: Michael
authors.initials: M
authors.lastname: Christodoulou
authors.forename: Christos
authors.initials: C
authors.lastname: Vottis
authors.forename: Panayiotis J
authors.initials: PJ
authors.lastname: Papagelopoulos
authors.forename: Dean G
authors.initials: DG
authors.lastname: Sotereanos
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D018771:Arthralgia / Q000517:prevention & control; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000601:surgery*; D000070599:Shoulder Injuries; D016038:Skin Transplantation; D013536:Suture Techniques; D016896:Treatment Outcome