title: Semitendinosus and gracilis free muscle-tendon graft for repair of massive rotator cuff tears: surgical technique.
abstract: Massive rotator cuff tears are difficult to treat surgically due to retraction, degeneration and fraying of the ends of torn tendons, severe fatty infiltration and atrophy of the respective muscles. Procedures developed to close the gap between the rotator cuff and the greater tuberosity of the humerus, such as soft tissue release may be inadequate for large tears. Human or porcine dermal allografts still have uncertain benefits, and tendon transfers seem to be associated with poor outcomes, donor site morbidity and altered mechanics. Reverse total shoulder arthroplasty has limited durability and is not indicated in young patients with high functional demands. We developed a new technique for repairing massive rotator cuff tears by semitendinosus and gracilis myotendinous grafting. This novel therapeutic option allows massive rotator cuff tears to be repaired using autologous material that is adequate and adaptable, making it possible to cover any width of defect. The technique is low-invasive and not technically demanding, with minimal donor site morbidity.
authors.affiliation: Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gigante
authors.affiliation: Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bottegoni
authors.affiliation: Department of Orthopaedics, Catholic University, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milano
authors.affiliation: Department of Reconstructive Plastic Surgery - Hand Surgery, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Riccio
authors.affiliation: Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Dei Giudici
keywords: rotator cuff augmentation; rotator cuff repair; rotator cuff tear; tendon transfer