Clinical outcomes and structural integrity after arthroscopic partial repair with patch augmentation for large to massive rotator cuff tears

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-05-01 Epub Date: 2026-02-09 DOI:10.1016/j.jor.2026.02.037

Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Chaemoon Lim, Seung Jin Kim

{"title":"Clinical outcomes and structural integrity after arthroscopic partial repair with patch augmentation for large to massive rotator cuff tears","authors":"Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Chaemoon Lim, Seung Jin Kim","doi":"10.1016/j.jor.2026.02.037","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Complete anatomic repair of large to massive rotator cuff tears (RCTs) is often not feasible because of tendon retraction, poor tissue quality, and advanced muscle degeneration. This study evaluates short-term clinical outcomes, complications, and postoperative structural integrity following arthroscopic partial rotator cuff repair with patch augmentation in patients with large to massive rotator cuff tears.</div></div><div><h3>Methods</h3><div>From May 2023 to December 2023, patients who underwent arthroscopic partial rotator cuff repair with patch augmentation for large to massive RCTS were retrospectively reviewed. Inclusion criteria were full-thickness supraspinatus tears with or without infraspinatus involvement, anteroposterior tear size >30 mm, and intraoperative confirmation that complete footprint coverage was not achievable. Exclusion criteria were loss to follow-up, prior shoulder instability surgery, and incomplete clinical data. Clinical outcomes were assessed preoperatively and at final follow-up using VAS pain, Constant, ASES, and SANE scores, range of motion (ROM), and forward elevation strength. Postoperative cuff integrity was evaluated with MRI, with subgroup analyses based on repair integrity.</div></div><div><h3>Results</h3><div>After exclusion of 16 patients, 90 patients were included, with a mean follow-up duration of 26.3 ± 2.1 months. Significant improvements were observed in pain, patient-reported outcome measures, ROM, and shoulder strength at final follow-up compared with preoperative values (all p < .001). Postoperative retear occurred in 18 patients (20.0%). Patients with intact repairs showed significantly superior pain relief, functional outcome scores, ROM, and strength compared with those who experienced retears (all p < .001). Other complications included shoulder stiffness in 8 patients (8.9%), infection in 2 patients (2.2%), and progression of glenohumeral arthritis in 3 patients (3.3%).</div></div><div><h3>Conclusion</h3><div>Arthroscopic partial repair with patch augmentation resulted in significant short-term improvements in pain, functional outcomes, ROM, and shoulder strength in patients with large to massive RCTs. Patients with intact repairs demonstrated superior clinical outcomes and achieved higher rates of clinically meaningful improvement compared with those in the retear group.</div></div><div><h3>Study design</h3><div>Case series; Level of evidence, IV.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"75 ","pages":"Pages 148-153"},"PeriodicalIF":1.5000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X26000681","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Complete anatomic repair of large to massive rotator cuff tears (RCTs) is often not feasible because of tendon retraction, poor tissue quality, and advanced muscle degeneration. This study evaluates short-term clinical outcomes, complications, and postoperative structural integrity following arthroscopic partial rotator cuff repair with patch augmentation in patients with large to massive rotator cuff tears.

Methods

From May 2023 to December 2023, patients who underwent arthroscopic partial rotator cuff repair with patch augmentation for large to massive RCTS were retrospectively reviewed. Inclusion criteria were full-thickness supraspinatus tears with or without infraspinatus involvement, anteroposterior tear size >30 mm, and intraoperative confirmation that complete footprint coverage was not achievable. Exclusion criteria were loss to follow-up, prior shoulder instability surgery, and incomplete clinical data. Clinical outcomes were assessed preoperatively and at final follow-up using VAS pain, Constant, ASES, and SANE scores, range of motion (ROM), and forward elevation strength. Postoperative cuff integrity was evaluated with MRI, with subgroup analyses based on repair integrity.

Results

After exclusion of 16 patients, 90 patients were included, with a mean follow-up duration of 26.3 ± 2.1 months. Significant improvements were observed in pain, patient-reported outcome measures, ROM, and shoulder strength at final follow-up compared with preoperative values (all p < .001). Postoperative retear occurred in 18 patients (20.0%). Patients with intact repairs showed significantly superior pain relief, functional outcome scores, ROM, and strength compared with those who experienced retears (all p < .001). Other complications included shoulder stiffness in 8 patients (8.9%), infection in 2 patients (2.2%), and progression of glenohumeral arthritis in 3 patients (3.3%).

Conclusion

Arthroscopic partial repair with patch augmentation resulted in significant short-term improvements in pain, functional outcomes, ROM, and shoulder strength in patients with large to massive RCTs. Patients with intact repairs demonstrated superior clinical outcomes and achieved higher rates of clinically meaningful improvement compared with those in the retear group.

Study design

Case series; Level of evidence, IV.

查看原文本刊更多论文

关节镜下补片增强部分修复大到大块肩袖撕裂后的临床结果和结构完整性

完全性解剖修复大到大面积肩袖撕裂（rct）通常是不可行的，因为肌腱挛缩、组织质量差和晚期肌肉退变。本研究评估了大到大面积肩袖撕裂患者在关节镜下部分肩袖补片增强修复后的短期临床结果、并发症和术后结构完整性。方法回顾性分析2023年5月至2023年12月在大到大面积随机对照试验中行关节镜下部分肩袖补片修复术的患者。纳入标准是累及或不累及冈下肌的全层冈上肌撕裂，前后撕裂大小为30mm，术中确认无法完全覆盖足印。排除标准为无随访、既往肩部不稳定手术和临床资料不完整。临床结果在术前和最终随访时通过VAS疼痛、Constant、ASES和SANE评分、活动范围（ROM）和前仰强度进行评估。术后用MRI评估袖带完整性，并根据修复完整性进行亚组分析。结果排除16例患者后，纳入90例患者，平均随访26.3±2.1个月。与术前相比，最终随访时疼痛、患者报告的结果测量、ROM和肩部力量均有显著改善（均p <； 0.001）。术后复发18例（20.0%）。完整修复的患者与经历修复的患者相比，疼痛缓解、功能结局评分、ROM和力量都有显著的优势（均p <； 0.001）。其他并发症包括8例（8.9%）患者肩关节僵硬，2例（2.2%）患者感染，3例（3.3%）患者肩关节关节炎进展。结论：在大到大规模的随机对照试验中，关节镜局部修复与补片增强可显著改善患者的疼痛、功能结局、ROM和肩部力量。与retear组相比，完整修复的患者表现出更好的临床结果，取得了更高的临床有意义的改善率。研究设计：案例系列；证据水平，IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.