title: Results of reconstruction of massive irreparable rotator cuff tears using a fascia lata allograft.
abstract: BACKGROUND
  Despite the advances in surgical treatment options, massive rotator cuff (r-c) tears still represent a challenge for orthopedic surgeons. This study assesses the effectiveness of fascia lata allograft in reconstruction of massive and irreparable r-c tear and to evaluate the healing and functional outcomes.
  
  
  METHODS
  68 patients (38 men, 30 women, mean age 64.9 years) with massive or irreparable r-c tears were treated with placement of fascia lata allograft to fill the defect between February 2006 and February 2010. At 43 months followup they were evaluated clinically using the constant score, preoperatively and postoperatively. Magnetic resonance imaging (MRI) and ultrasound were used postoperatively, to assess the integrity of the allograft at the repair site. Postoperatively, standard rehabilitation protocol was followed with gradual restoration.
  
  
  RESULTS
  Postoperative constant score increased from 32.5 preoperatively to 88.7 postoperatively. The most important was the pain relief from 2.4 preoperatively to 14.1 postoperatively and range of motion. The results of the MRI were not reliable, but the ultrasound was satisfactory. Finally, there was no infection or rejection of the graft in any of the patients.
  
  
  CONCLUSIONS
  Despite advances in surgical methods, there is still not a universally accepted treatment for massive and irreparable rotator cuff tears, because the standard methods have dubious results, with excessive retear rates and poor outcomes, necessitating the need for new repair strategies. We documented significant clinical improvement using fascia lata allograft in the repair of massive irreparable r-c tear, acting as scaffold to bridge the defect, enhancing the healing at the repair site.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Varvitsiotis
authors.affiliation: Department of Orthopedic Surgery, Asclepieion Voulas, 16673, Athens, Greece.
authors.forename: Varvitsiotis
authors.initials: V
authors.lastname: Dimitrios
authors.forename: Athanasios
authors.initials: A
authors.lastname: Papaspiliopoulos
authors.affiliation: Department of Orthopedic Surgery, Asclepieion Voulas, 16673, Athens, Greece.
authors.forename: Papaspiliopoulos
authors.initials: P
authors.lastname: Athanasios
authors.forename: Eleni
authors.initials: E
authors.lastname: Antipa
authors.affiliation: Department of Radiology, General Hospital 'G. Gennimatas', Athens, Greece.
authors.forename: Antipa
authors.initials: A
authors.lastname: Eleni
authors.forename: Xenofon
authors.initials: X
authors.lastname: Papacharalampous
authors.affiliation: Department of Radiology Areteion University Hospital, Athens, Greece.
authors.forename: Papacharalampous
authors.initials: P
authors.lastname: Xenofon
authors.forename: George
authors.initials: G
authors.lastname: Flevarakis
authors.affiliation: Department of Orthopedic Surgery, Asclepieion Voulas, 16673, Athens, Greece.
authors.forename: Flevarakis
authors.initials: F
authors.lastname: George
authors.affiliation: Department of Orthopedic Surgery, Asclepieion Voulas, 16673, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Feroussis
authors.forename: Feroussis
authors.initials: F
authors.lastname: John
keywords: Allograft; Allograft reconstruction; fascia lata allograft; patch graft; rotator cuff; rotator cuff repair; rotator cuff tear; shoulder