Long-term clinical and radiographic outcome of rotator cuff repair with a synthetic interposition graft: a consecutive case series with 17 to 20 years of follow-up
These authors sought the long term outcomes of treatment for 13 irreparable cuff tears using synthetic interposition grafts made of Dacron to bridge the defect between the residual tendon and the tuberosity. The patients included 11 men and 2 women with a mean age of 55 years (range, 38-72 years).
These authors sought the long term outcomes of treatment for 13 irreparable cuff tears using synthetic interposition grafts made of Dacron to bridge the defect between the residual tendon and the tuberosity. The patients included 11 men and 2 women with a mean age of 55 years (range, 38-72 years).
After a mean of 18 years (range, 17-20 years), 1 patient had died, and 12 were available for x-ray imaging and 10 also for ultrasonography and clinical scores. Cuff tear arthropathy (Hamada grade ≥2) had developed in 9 of 12 (75%; 95% confidence interval, 43%-95%), including 3 patients operated on with arthroplasty in the follow-up period.
The mean absolute Constant-Murley score was 46 (standard deviation, 26), and the mean Western Ontario Rotator Cuff score was 59 (standard deviation, 20). In 7 of 10 patients (70%) with available ultrasonography, the graft was interpreted as not intact.
All patients had a contralateral full-thickness tear, and 7 of 12 patients (58 %; 95% confidence interval, 28%-85%) had contralateral cuff tear arthropathy. The number of patients with cuff tear arthropathy was not significantly different between the shoulder repaired with a Dacron graft and the contralateral shoulder (P = .667).
Comment: Here we have a common issue in clinical research. Patients want to know the long term results of the treatment they are considering. But usually we can only give them either (1) the long term results of a method no longer in use (such as a Dacron graft)
or (2) the short term results of a new type of graft
as shown in a recent post (see this link)
or even a balloon
or (2) the short term results of a new type of graft
as shown in a recent post (see this link)
or even a balloon
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