Comparable clinical outcome with greater thickness and lesser re-tear rate following allogenous dermal scaffold augmentation for large to massive rotator cuff tears: a retrospective case-controlled study.

Abstract

Background: Allogenous dermal scaffold augmentation enhances partial rotator cuff repairs by providing structural support and a biologic scaffold that promotes tissue regeneration, reduces mechanical strain, and compensates for poor tendon quality in large to massive rotator cuff tears. This approach helps lower the risk of retear and improves functional recovery.

Methods: This study included 55 patients with large to massive rotator cuff tears, divided into two groups. Group A (28 patients) underwent arthroscopic partial repair, while Group B (27 patients) received allogenous dermal scaffold graft augmentation following partial repair to reinforce the repair and resurface the uncovered tendon footprint. Clinical assessments, including the University of California-Los Angeles score, Constant-Murley score, and visual analogue scale, were conducted preoperatively, at 3, 6, and 12 months postoperatively, and annually thereafter. Radiologic evaluations, including magnetic resonance imaging and ultrasonography, were performed preoperatively and postoperatively to assess tendon integrity.

Results: The mean follow-up period was 40 months for Group A and 36 months for Group B. Clinical functional scores significantly improved in both groups at the final follow-up. Postoperative radiologic assessment showed 9 retears in Group A and 4 in Group B (p < 0.05), respectively, with significantly greater postoperative tendon thickness in Group B compared to Group A (p-value < 0.05). Additionally, acromiohumeral distance improved significantly in both groups, from 7 mm to 9 mm in Group A and from 7 mm to 11 mm in Group B, with Group B demonstrating superior improvement (p < 0.01).

Conclusion: This study suggests that allogenous dermal scaffold graft augmentation, in addition to partial repair, enhances tendon thickness and acromiohumeral distance. Furthermore, it results in lower retear rates compared to partial repair alone.