Original articleSix-month magnetic resonance imaging follow-up of large and massive rotator cuff repairs reinforced with porcine small intestinal submucosa
Section snippets
Materials and methods
We retrospectively selected 11 consecutive patients with large (1) and massive (10) rotator cuff tears treated with open repair and SIS augmentation, and their charts were reviewed. The patient cohort consisted of 5 women and 6 men. On their initial visit, patients filled out a modified shoulder questionnaire, and a shoulder score was calculated by use of the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment.28 Surgeries were performed between September 2000 and
Results
The mean age of the patients involved in this study was 67.5 years. Of 11 patients, 8 (73%) had tears in their dominant shoulder. The mean preoperative shoulder score was 60.3. The mean postoperative shoulder score was 58.4. The length of follow-up ranged from 6 to 10 months postoperatively. Postoperative magnetic resonance images revealed retears in 10 of 11 shoulders with recurrence of large, retracted tears. Only 1 patient had an intact repair on MRI at 10 months. Despite an intact cuff on
Discussion
On the basis of our results, we believe that an SIS scaffold will not allow for successful reconstruction of the large to massive rotator cuff tear, especially in the setting of muscle atrophy. All of the subjects in this study had extensive atrophy and retraction of their supraspinatus and infraspinatus muscles on their preoperative magnetic resonance images, which was confirmed at the time of surgery. MRI in the evaluation of postoperative shoulders is controversial. There is some consensus
References (32)
Arthroscopic debridement and decompression for selected rotator cuff tears. Clinical results, pathomechanics, and patient selection based on biomechanical parameters
Orthop Clin North Am
(1993)- et al.
Intestine submucosa and polypropylene mesh for abdominal wall repair in dogs
J Surg Res
(1996) - et al.
Rotator cuff repair tension as a determinant of functional outcome
J Shoulder Elbow Surg
(2000) - et al.
Magnetic resonance imaging of the postoperative shoulder
Magn Reson Imaging Clin N Am
(1993) - et al.
Experimental assessment of small intestinal submucosa as a bladder wall substitute
Urology
(1995) - et al.
MR imaging of the postoperative shoulder
Magn Reson Imaging Clin N Am
(1997) - et al.
A standardized method for the assessment of shoulder function
J Shoulder Elbow Surg
(1994) - et al.
Naturally occurring extracellular matrix as a scaffold for musculoskeletal repair
Clin Orthop
(1999) - et al.
Small intestinal submucosaa substrate for in vitro cell growth
J Biomater Sci Polym Ed
(1998) - et al.
The use of xenogeneic small intestinal submucosa as a biomaterial for Achilles' tendon repair in a dog model
J Biomed Mater Res
(1995)