Houston Methodist. Leading Medicine

Shoulder News

Surgeons Give Thumbs Down to Treatment for Massive Rotator Cuff Tears

There isn't a good way to treat massive tears of the rotator cuff in the shoulder. In fact, some doctors label them “irreparable.” In this study, surgeons at the University of California - Los Angeles tried repairing 32 shoulders with massive, irreparable rotator cuff tears (RCTs) using an allograft reconstruction. They report it isn't the treatment they'd hoped for.

RCTs are described as "massive" if two or more of the four tendons are ruptured and a tendon repair fails. Allografting uses donated quadriceps, patellar, or Achilles tendons. The surgical method used to reconstruct the shoulder with the allograft is described.

MRIs taken after the surgery showed complete failure in all cases. The grafted tissue was no longer attached to the bone. The head of the humerus had drifted or migrated upwards. Despite these results the patients reported improved pain and function. Only one patient had a graft rejection.

The authors concluded allograft repair of massive RCTs doesn't give better results than other methods of repair. Since it's more expensive with a higher risk of graft rejection and infection, they don't recommend using this method.

David R. Moore, MD, et al. Allograft Reconstruction for Massive, Irreparable Rotator Cuff Tears. In The American Journal of Sports Medicine. March 2006. Vol. 34. No. 3. Pp. 392-396.


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