Rotator cuff repair using an original iliotibial ligament with a bone block patch: preliminary results with a 24-month follow-up period

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• 作者：Shuzou Mihara ; MD^a ; ^{smihara@yamaguchi.saiseikai.or.jp" class="auth_mail" title="E-mail the corresponding author} ; Takeshi Fujita ; MD^b ; Teruyasu Ono ; MD^a ; Hirofumi Inoue ; MD^a ; Tetsurou Kisimoto ; MD^a
• 关键词：Level IV ; Case Series ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：25
• 期：7
• 页码：1155-1162
• 全文大小：1632 K

文摘

Our first-line choice of surgical method for massive shoulder rotator cuff tears not amenable to primary repair is a patching method that uses a graft consisting of a section of the iliotibial band with an attached bone block. The objective of this study was to examine the functional and structural results.

Methods

The study included 5 patients who were not eligible for primary repair, received iliotibial band autografts with an attached bone block, and could be monitored for 2 years or more. The grafting method involved suturing the ligament part of the graft to the remaining rotator cuff and fixing the bone part to the greater tubercle of the humerus by means of a suture-bridge technique. Clinical evaluation was performed for 24 months postoperatively. Postoperative structural evaluation was performed using computed tomography at 3 to 4 months and magnetic resonance imaging at 6, 12, and 24 months.

Results

A clear improvement was seen at the final clinical evaluation. Fusion of the bone graft with the greater tubercle of the humerus was confirmed on computed tomography in all patients. No retearing was observed on magnetic resonance imaging at the 24-month point, and the thickness of the ligament part of the graft was maintained.

Conclusion

The patching method using an iliotibial band with an attached bone block as the graft enabled good reconstruction of the rotator cuff, including the greater tubercle footprint. Moreover, good clinical results were seen at 24 months.