ArticleBMC musculoskeletal disorders2025
A novel side-to-side triple-row repair combined with biceps tendon augmentation for massive rotator cuff tears: a case series demonstrating satisfactory short-term outcomes.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundTo evaluate the clinical and radiological outcomes of a novel side-to-side triple-row repair combined with long head of biceps tendon augmentation for the treatment of massive rotator cuff tears (MRCTs).
methodsBetween January 2022 and July 2023, patients diagnosed with MRCTs who underwent this combined repair technique were prospectively included and retrospectively reviewed. Shoulder range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley (CM) score were assessed preoperatively and at the final follow-up. Preoperative magnetic resonance imaging (MRI) was used to evaluate tendon retraction and fatty infiltration of rotator cuff muscles. MRI at least 1 year after surgery was performed to determine the integrity of the repaired tendons and fatty infiltration of rotator cuff muscles.
resultsThirty-four patients met the eligibility criteria. The average age was 63.8 ± 5.9 years (range, 50.0-74.0), with a mean follow-up of 23.8 ± 5.5 months (range, 12.0-36.0). All measured outcomes (ROM, ASES, and CM) showed significant improvement from preoperative to final follow-up (p < 0.001 for all). MRI imaging at least one year after surgery showed that 10 patients (29.4%) had a retear of the repaired rotator cuff tendons. Compared with those whose tendons remained healed, patients with retorn tendons demonstrated significantly lower ROM (except internal rotation) and poorer clinical scores (p < 0.01 for all). No significant overall changes were observed in supraspinatus and infraspinatus fatty infiltration after surgery. However, the retorn group showed significantly higher preoperative (P = 0.022) and postoperative (P = 0.002) supraspinatus fatty infiltration compared to the healed group, with progression in 20% of retorn patients versus 8.3% in the healed group.
conclusionsThis side-to-side triple-row repair combined with biceps tendon augmentation led to satisfactory short-term clinical outcomes in patients with MRCTs. However, retears still occurred in nearly one-third of patients, and those with retorn tendons had reduced ROM and worse functional scores relative to patients with healed repairs. Supraspinatus and infraspinatus fatty infiltration remained largely unchanged postoperatively, but higher supraspinatus fatty infiltration in the retorn group was significantly associated with poorer healing outcomes.
trial registrationThis study was approved by the Institutional Review Board (IRB) of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Approval No. 2023-KY-166 K) on November 3rd, 2023. CLINICAL TRIAL NUMBER: not applicable.
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