title: Achilles tendon allograft for an irreparable massive rotator cuff tear with bony deficiency of the greater tuberosity.
abstract: Management of combined bony and tendinous deficiency of the posterosuperior rotator cuff represents a challenge in young patients. In this case report, a 44-year-old woman that presented an osteonecrosis of the greater tuberosity had a pseudoparalytic shoulder. She beneficiated from a fresh-frozen Achilles tendon allograft with calcaneal bone, which was used to reconstruct the rotator cuff and the concomitant bony defect. At 12-month follow-up, the patient was pain free and had complete range of motion, normal strength, a SANE score of 95 and radiographically the allograft was healed. An Achilles tendon allograft may therefore be a viable surgical option to reconstruct a combine posterosuperior rotator cuff tear and greater tuberosity bone defect. Level of evidence IV.
authors.affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland.|Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva, Switzerland.|Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lädermann
authors.affiliation: Southern Oregon Orthopedics, Medford, OR, USA.|Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Denard
authors.affiliation: Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Abrassart
authors.affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland. adrien.schwitzguebel@latour.ch.
authors.forename: Adrien J-P
authors.initials: AJ
authors.lastname: Schwitzguébel
mesh_terms: D000125:Achilles Tendon; D064591:Allografts; D006801:Humans; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D014184:Transplantation, Homologous
keywords: Achilles allograft; Bone and tendon insufficiency; Function; Massive rotator cuff; Outcome; Treatment
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