title: Rotator cuff repair using an original iliotibial ligament with a bone block patch: preliminary results with a 24-month follow-up period.
abstract: BACKGROUND
  Our first-line choice of surgical method for massive shoulder rotator cuff tears not amenable to primary repair is a patching method that uses a graft consisting of a section of the iliotibial band with an attached bone block. The objective of this study was to examine the functional and structural results.
  
  
  METHODS
  The study included 5 patients who were not eligible for primary repair, received iliotibial band autografts with an attached bone block, and could be monitored for 2 years or more. The grafting method involved suturing the ligament part of the graft to the remaining rotator cuff and fixing the bone part to the greater tubercle of the humerus by means of a suture-bridge technique. Clinical evaluation was performed for 24 months postoperatively. Postoperative structural evaluation was performed using computed tomography at 3 to 4 months and magnetic resonance imaging at 6, 12, and 24 months.
  
  
  RESULTS
  A clear improvement was seen at the final clinical evaluation. Fusion of the bone graft with the greater tubercle of the humerus was confirmed on computed tomography in all patients. No retearing was observed on magnetic resonance imaging at the 24-month point, and the thickness of the ligament part of the graft was maintained.
  
  
  CONCLUSIONS
  The patching method using an iliotibial band with an attached bone block as the graft enabled good reconstruction of the rotator cuff, including the greater tubercle footprint. Moreover, good clinical results were seen at 24 months.
authors.affiliation: Department of Orthopaedic Surgery, Saiseikai Yamaguchi General Hospital, Yamaguchi, Japan. Electronic address: smihara@yamaguchi.saiseikai.or.jp.
authors.forename: Shuzou
authors.initials: S
authors.lastname: Mihara
authors.affiliation: Department of Radiology, Ube Industries Ltd Central Hospital, Ube, Yamaguchi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Department of Orthopaedic Surgery, Saiseikai Yamaguchi General Hospital, Yamaguchi, Japan.
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Ono
authors.affiliation: Department of Orthopaedic Surgery, Saiseikai Yamaguchi General Hospital, Yamaguchi, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Department of Orthopaedic Surgery, Saiseikai Yamaguchi General Hospital, Yamaguchi, Japan.
authors.forename: Tetsurou
authors.initials: T
authors.lastname: Kisimoto
mesh_terms: D000368:Aged; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery; D008023:Ligaments, Articular / Q000637:transplantation*; D008279:Magnetic Resonance Imaging; D008297:Male; D011184:Postoperative Period; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Rotator cuff; arthroscopy; autograft; bone block; iliotibial ligament; rotator cuff augmentation