Midterm outcomes of revision biceps tendon augmentation without tear completion for high-grade partial articular-sided supraspinatus retear

TL;DR

This study shows that a specific surgical technique for repairing complex shoulder tendon tears provides good results over the medium term.

Contribution

Demonstrates the effectiveness of biceps tendon augmentation without tear completion for high-grade supraspinatus retear.

Findings

Significant improvements in pain and shoulder function scores were observed post-surgery.

MRI showed good tendon integrity with no retears or muscle deterioration.

Tendon thickness increased significantly after the procedure.

Abstract

To evaluate the midterm clinical and radiological outcomes of revision biceps tendon augmentation without tear completion for high-grade partial articular-sided supraspinatus retear (PASR) lesions, which present challenges due to poor tendon quality.

From January 2014 to May 2023, a total of 22 patients (mean age: 57.2 ± 13.6 years, 8 males and 14 females) who underwent revision cuff repair with biceps tendon augmentation without tear completion for PASR lesions following arthroscopic rotator cuff repair were enrolled in our study. Clinical and radiological outcomes, including tendon integrity (Sugaya classification), were evaluated at the last follow-up.

Previous rotator cuff tears included 10 full-thickness rotator cuff tears and 12 partial-thickness rotator cuff tears. The mean interval between the primary and revision surgeries was 5.9 ± 6.0 years (range, 0.4-14 years). Significant improvements were observed in all clinical outcome scores at the final follow-up. The mean visual analog scale for pain improved from 3.8 preoperatively to 0.6 postoperatively. American Shoulder and Elbow Surgeons scores improved from 64 to 94, University of California, Los Angeles shoulder scores from 22 to 33, Simple Shoulder Test scores from 7 to 11, and Korean Shoulder Scoring System scores from 71 to 94 (all P values <.001). Follow-up magnetic resonance imaging demonstrated good tendon integrity, with Sugaya type I in 6 cases, type II in 15 cases, and type IV in 1 case. Mean tendon thickness increased from 4.6 mm to 7.4 mm. There were no retears, and no progression of fatty infiltration or muscle atrophy was observed.

High-grade PASR lesions following arthroscopic rotator cuff repair are uncommon and challenging due to poor tendon quality. Revision biceps tendon augmentation without tear completion appears to be a reliable surgical option for PASR lesions, yielding favorable midterm functional and radiological outcomes.

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