title: Outcomes of Combined Bone Marrow Stimulation and Patch Augmentation for Massive Rotator Cuff Tears.
abstract: BACKGROUND
  The high failure rate after surgical repair of massive rotator cuff tears is a consistent problem.
  
  
  OBJECTIVE
  To evaluate the clinical and radiological outcomes of arthroscopic rotator cuff repair with bone marrow stimulation and patch augmentation in patients with massive rotator cuff tears.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  This study included 21 patients who underwent bone marrow stimulation and patch augmentation (group 1) and 54 patients who underwent conventional repair (group 2) for massive rotator cuff tears. Postoperative clinical outcomes were evaluated based on visual analog scale (VAS) for pain, simple shoulder test (SST), University of California, Los Angeles (UCLA), Constant, and American Shoulder and Elbow Surgeons (ASES) scores at baseline, 1 year postoperatively, and final follow-up. Anatomic outcomes were evaluated by using postoperative magnetic resonance imaging at 1 year after surgery.
  
  
  RESULTS
  No significant differences in demographic characteristics and baseline data were observed between groups 1 and 2. Clinical symptoms were significantly improved at the final follow-up in both groups (P < .001). At the final follow-up, no significant differences were found in VAS pain (P = .676), SST (P = .598), UCLA (P = .100), Constant (P = .469), or ASES (P = .880) scores. However, the retear rate was lower in group 1 (4/21, 19.0%) than in group 2 (25/54, 46.3%) (P = .036), and the medial-row failure rate (type 2 retears) was much lower in group 1 (0/4, 0%) than in group 2 (18/25, 72.0%) (P = .014).
  
  
  CONCLUSIONS
  Concomitant bone marrow stimulation and patch augmentation significantly reduced retear and medial-row failure rates in the arthroscopic repair of massive rotator cuff tears.
authors: Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors: Jong Pil
authors: JP
authors: Yoon
authors: Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea smilecsw@gmail.com.
authors: Seok Won
authors: SW
authors: Chung
authors: Department of Orthopaedic Surgery, Chung-Ang University School of Medicine, Seoul, Korea.
authors: Jae Yoon
authors: JY
authors: Kim
authors: Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors: Byung Joo
authors: BJ
authors: Lee
authors: Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors: Hyung-Sub
authors: HS
authors: Kim
authors: Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors: Ju Eun
authors: JE
authors: Kim
authors: Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea.
authors: Jung Hyun
authors: JH
authors: Cho
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D001853:Bone Marrow; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D016038:Skin Transplantation; D053441:Suture Anchors; D064232:Visual Analog Scale; D014945:Wound Healing
keywords: bone marrow stimulation; massive rotator cuff tear; medial-row failure; patch graft; retear; tendon-to-bone healing