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A retrospective comparative study of surgical outcomes following femoral fascia patching and iliotibial ligament bony patching for primary irreparable rotator cuff tears in a geriatric population

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

We performed two surgical techniques for primary irreparable rotator cuff tears: a patch technique using the femoral fascia as a graft (F technique) and a patch technique using the bony iliotibial ligament (I technique). We then evaluated the outcomes of both surgical methods.

Materials and methods

This study included 28 patients who were diagnosed with primary irreparable rotator cuff tears from April 2008 to April 2014. Among them, 13 underwent the F technique, whereas 15 underwent the I technique. Each clinical shoulder score was evaluated preoperatively and 2 years after surgery. The cuff integrity was evaluated via magnetic resonance imaging 2 years after surgery, with cases suffering a retear after surgery undergoing retear site examination. In group I, computed tomography (CT) was performed 3–4 months after surgery to investigate the bony part of the patch and bony fusion of the footprint.

Results

Both groups showed significant improvements in the pre- and postoperative mean clinical score values. Group I had significantly better postoperative scores than group F. Postoperative retear rates were 33.3% and 76.9% for groups I and F, respectively, with group I having a significantly lower retear rate (P = 0.03). All 5 retears in group I were located at the suture between the residual rotator cuff and the graft, whereas 7 of the 10 retears in group F were located at the fixation of the graft and footprint and the remaining 3 were central. CT results in group I showed that all 15 patients had bony fusion between the bony part of the patch and the footprint.

Conclusion

The I technique was significantly superior to the F technique in terms of postoperative clinical scores and retear rates, suggesting its advantage for rotator cuff tissue reconstruction.

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Data availability

The dataset generated during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are grateful to Dr. Y. Hattori for the statistical analyses.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Saiseikai Yamaguchi General Hospital, 2-11 Midori-cho, Yamaguchi, 753-8517, Japan

    Shuzou Mihara & Teruyasu Ohno

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  1. Shuzou Mihara
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Contributions

SM: Wrote the paper, performed the analysis, conceived and designed the analysis. TO: Data collection, contributed data/analysis tools.

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Correspondence to Shuzou Mihara.

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The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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This study received institutional review board approval (H25-6).

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Informed consent for participation in the study was obtained from all patients.

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Mihara, S., Ohno, T. A retrospective comparative study of surgical outcomes following femoral fascia patching and iliotibial ligament bony patching for primary irreparable rotator cuff tears in a geriatric population. Arch Orthop Trauma Surg 144, 987–995 (2024). https://doi.org/10.1007/s00402-023-05150-z

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