JSES - 2026-05-12 - Journal Article
Postoperative Outcomes of Modified Graft Augmentation for Large to Massive Rotator Cuff Tears.
Ohta S, Masuda S, Ueda Y, Komai O
Topics
Key Takeaway
A modified graft augmentation technique using a double suture bridge configuration achieved 0% retear rate at minimum 2-year follow-up in 30 patients with large to massive rotator cuff tears.
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Summary
This study evaluated clinical and radiological outcomes of a modified graft augmentation technique using a double suture bridge configuration for large to massive rotator cuff tears in 30 patients with minimum 2-year follow-up. JOA scores, UCLA scores, ROM, strength, acromiohumeral distance, and MRI-based Sugaya classification integrity were assessed pre- and postoperatively. All clinical parameters improved significantly and MRI showed 0% retear rate, with no significant outcome difference between pseudoparalytic and non-pseudoparalytic subgroups.
Key Limitation
The single-arm design with n=30 and no comparator group makes it impossible to determine whether the 0% retear rate reflects the augmentation technique or patient selection bias.
Original Abstract
BACKGROUND
The re-tear rate after rotator cuff repair for large to massive tears remains high, and improving postoperative outcomes is a clinical challenge. This study aimed to evaluate the clinical and radiological outcomes of a modified graft augmentation technique using a double suture bridge (DSB) configuration.
METHODS
Thirty patients with large to massive rotator cuff tears who underwent the modified graft augmentation procedure after February 2017 and were followed for at least 2 years were included in this study. Pre- and postoperative Japanese Orthopaedic Association scores, University of California at Los Angeles scores, range of motion, muscle strength, acromiohumeral distance, and cuff integrity, assessed via magnetic resonance imaging (MRI) using the Sugaya classification, were evaluated. Subgroup analyses were performed according to the presence or absence of pseudoparalytic shoulder.
RESULTS
All clinical parameters showed significant improvement at 2 years postoperatively compared with preoperative values. Postoperative MRI demonstrated maintained cuff integrity, with no re-tears observed at the final evaluation. There were no statistically significant differences in postoperative outcomes between patients with and without a pseudoparalytic shoulder.
CONCLUSION
The modified graft augmentation technique using a DSB configuration demonstrated favorable clinical outcomes and maintained structural integrity in patients with large to massive rotator cuff tears.