title: Surgical repair of massive rotator cuff tendon tears: Autologous quadriceps tendon graft versus arthroscopic repair.
abstract: Massive rotator cuff tear repair results are variable. The main purpose of this study was to compare functional outcome between two procedures: open repair by autologous quadriceps-patella tendon patch, and arthroscopic suture. The study hypothesis was that there is no significant difference in results between the two techniques.
  
  
  
  A retrospective study included all patients younger than 70 years operated on from 1995 to 2013 for massive rotator cuff tear. Exclusion criteria comprised history of dislocation, fracture or surgery or osteoarthritis in the affected shoulder, and infra- and supra-spinatus fatty degeneration equal to or greater than stage 3. Two consecutive groups were distinguished: group 1, from 1995 to 2003, comprised 23 patients (24 shoulders; mean age, 55.8 years) treated by open repair using quadriceps tendon autograft; group 2, from 2003 to 2013, comprised 27 patients (29 shoulders: mean age, 60.3 years) treated by arthroscopic repair.
  
  
  
  Preoperatively, mean Constant score was 42.9 in group 1 and 45.7 in group 2 (P=0.36), pain score 5.5/15 and 7.6/15 (P=0.08), strength 3.0kg and 2.4kg (P=0.30), and subacromial space 6.3 and 6.7mm (P=0.05), respectively. At respectively 58 and 55 months' mean follow-up, Constant score was 71.1 in group 1 and 71.8 in group 2 (P=0.086), pain 11.9/15 and 12.7/15 (P=0.76), gain in strength 1.4kg and 2.3kg (P=0.0006), and subacromial space 7.1mm and 6.3mm (P=0.29), respectively. The complications rate was 70% in group 1 and there were no specific complications in group 2.
  
  
  
  Functional improvement was significant and comparable between the 2 groups. Quadriceps tendon harvesting was associated with high morbidity, but the technique increased subacromial space.
  
  
  
  IV, retrospective, single-center.
authors.affiliation: Service d'Orthopédie et de Traumatologie, CH A. Mignot Versailles, 177 Rue de Versailles, 78157 Le Chesnay, France.
authors.forename: C
authors.initials: C
authors.lastname: Tempelaere
authors.affiliation: Service d'Orthopédie et de Traumatologie, CH A. Mignot Versailles, 177 Rue de Versailles, 78157 Le Chesnay, France. Electronic address: pdesmoineaux@ch-versailles.fr.
authors.forename: P
authors.initials: P
authors.lastname: Desmoineaux
authors.affiliation: Service d'Orthopédie, Clinique Jules Verne, 2 Route de Paris, 44300 Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Lespagnol
authors.affiliation: Service d'Orthopédie et de Traumatologie, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Pierrart
authors.affiliation: Service d'Orthopédie et de Traumatologie, CH A. Mignot Versailles, 177 Rue de Versailles, 78157 Le Chesnay, France.
authors.forename: P
authors.initials: P
authors.lastname: Beaufils
authors.affiliation: Service d'Orthopédie et de Traumatologie, CH A. Mignot Versailles, 177 Rue de Versailles, 78157 Le Chesnay, France.
authors.forename: N
authors.initials: N
authors.lastname: Pujol
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000150:complications / Q000601:surgery*; D012782:Shoulder / Q000503:physiopathology*; D012785:Shoulder Joint / Q000503:physiopathology* / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology; D013537:Sutures; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Comparison; Massive rotator cuff tear; Quadriceps tendon graft; Shoulder arthroscopy