title: Arthroscopic modified Mason-Allen technique for large U- or L-shaped rotator cuff tears.
abstract: OBJECTIVE
  While a conventional single- or double-row repair technique could be applied for repair of C-shaped tears, a different surgical strategy should be considered for repair of U- or L-shaped tears because they typically have complex patterns with anterior, posterior, or both mobile leaves. This study was performed to examine the outcomes of the modified Mason-Allen technique for footprint restoration in the treatment of large U- or L-shaped rotator cuff tears.
  
  
  METHODS
  Thirty-two patients who underwent an arthroscopic modified Mason-Allen technique for large U- or L-shaped rotator cuff tears between January 2012 and December 2013 were included in this study. Margin convergence was first performed to reduce the tear gap and tension, and then, an arthroscopic Mason-Allen technique was performed to restore the rotator cuff footprint in a side-to-end repair fashion. All patients were evaluated preoperatively and for a minimum of 2 years of follow-up with a visual analog scale (VAS) for pain, Constant score, and ultrasonography.
  
  
  RESULTS
  There was significant improvement in all VAS and Constant scores compared with the preoperative values (P < 0.001). Functional results by Constant scores included 9 cases that were classified as excellent, 11 cases as good, 8 cases as fair, and 2 cases as poor. Binary logistic regression analysis revealed that heavy work, pseudoparalysis, joint space narrowing, fatty degeneration of the SST and IST, and a positive tangent sign were found to significantly correlate with functional outcomes. Multivariable logistic regression analysis revealed that only fatty degeneration of the SST was a risk factor for fair/poor clinical outcomes. Complications occurred in 5 of the 32 patients (15.6 %), and the reoperation rate due to complications was 6.3 % (2 of 32 patients).
  
  
  CONCLUSIONS
  An arthroscopic modified Mason-Allen technique was sufficient to restore the footprint of the rotator cuff in our data. Overall satisfactory results were achieved in most patients, with the exception of those with severe fatty degeneration. An arthroscopic modified Mason-Allen technique could be an effective and reliable alternative for patients with large U- or L-shaped rotator cuff tears.
  
  
  METHODS
  Case Series, Therapeutic Level IV.
authors: Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung 2-Dong, Changwon-si, Gyeongsangnam-do, Korea. can1204@hanmail.net.
authors: Sung-Weon
authors: SW
authors: Jung
authors: Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung 2-Dong, Changwon-si, Gyeongsangnam-do, Korea.
authors: Dong-Hee
authors: DH
authors: Kim
authors: Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung 2-Dong, Changwon-si, Gyeongsangnam-do, Korea.
authors: Seung-Hoon
authors: SH
authors: Kang
authors: Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung 2-Dong, Changwon-si, Gyeongsangnam-do, Korea.
authors: Ji-Heon
authors: JH
authors: Lee
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D000070636:Rotator Cuff Injuries / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D064232:Visual Analog Scale; D014945:Wound Healing
keywords: Large size; Margin convergence; Mason-Allen technique; Rotator cuff tear; Shoulder