Arthroscopy - 2026-03-08 - Journal Article
Improved Patient-Reported Outcomes Following Human Dermal Allograft Patch Augmentation With Footprint Medialization in Arthroscopic Partial Repair of Retracted Rotator Cuff Tears.
Kim SH, Shin SJ
Topics
Key Takeaway
Arthroscopic partial repair with footprint medialization and HDA patch augmentation achieved a 7.5% retear rate and mean ASES improvement from 68.4 to 93.7 in retracted rotator cuff tears >2.5 cm with residual footprint exposure >1.5×1.5 cm.
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Summary
This study evaluated arthroscopic partial repair with footprint medialization plus HDA patch augmentation in patients with retracted full-thickness rotator cuff tears >2.5 cm where residual footprint exposure exceeded 1.5×1.5 cm after medialization <1 cm. Forty patients (mean age 64.5 years) were prospectively enrolled and assessed with ASES, Constant, SANE, VAS, and MRI/ultrasound surveillance. All PRO scores improved significantly (p<0.001), all patients exceeded MCID, and retear rate was 7.5% (3/40) at 6-month MRI with no additional retears on annual ultrasound.
Key Limitation
The absence of a control group (partial repair without augmentation) makes it impossible to determine whether the HDA patch independently contributed to the low retear rate and PRO improvements.
Original Abstract
PURPOSE
To evaluate the clinical and radiologic outcomes of arthroscopic partial repair combined with human dermal allograft (HDA) patch augmentation in patients with retracted rotator cuff tears larger than 2.5 cm, where complete footprint coverage was not feasible.
METHODS
We prospectively enrolled patients with retracted full-thickness rotator cuff tears measuring larger than 2.5 cm. Indication for human dermal allograft patch augmentation was residual footprint exposure exceeding 1.5 × 1.5 cm after arthroscopic rotator cuff repair with footprint medialization less than 1 cm. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score, Constant score, Single Assessment Numeric Evaluation, Visual Analog Scale for pain, and active range of motion. The minimal clinically important difference was calculated using the American Shoulder and Elbow Surgeons score. Retear was evaluated via magnetic resonance imaging at 6 months and annual ultrasound examination.
RESULTS
Forty patients (mean age 64.5 ± 8.8 years) were included. The minimum follow-up was 17 months, with a mean of 19.7 ± 2.5 months (range, 17-28 months). At final follow-up, clinical outcomes improved significantly: Visual Analog Scale from 4.9 ± 1.8 to 0.4 ± 0.5, Single Assessment Numeric Evaluation from 31.7 ± 18.2 to 94.1 ± 8.3, American Shoulder and Elbow Surgeons from 68.4 ± 16.8 to 93.7 ± 5.3, and Constant from 61.1 ± 15.1 to 89.2 ± 5.7 (P < .001). Active range of motion also increased significantly (P < .001). All patients exceeded the minimal clinically important difference. Retear occurred in 3 patients (7.5%) on 6-month magnetic resonance imaging. No additional retears were found on annual ultrasound examination.
CONCLUSIONS
Arthroscopic partial repair with footprint medialization and human dermal allograft patch augmentation yielded significant improvements in patient-reported outcomes and a low retear rate for retracted rotator cuff tears, especially when the tear size more than 2.5 cm and residual footprint exposed area is exceeding 1.5 × 1.5 cm after medialization to less than 1 cm.
LEVEL OF EVIDENCE
Level IV, retrospective case series.