Arthroskopische Rotatorenmanschettenrekonstruktion mit Patch-Augmentation

Abstract

SURGICAL OBJECTIVE: Augmentation of the rotator cuff with an ECM patch during arthroscopic rotator cuff repair is performed in order to unload the reconstruction and to activate biological healing. Reconstructable rotator cuff ruptures with reduced tendon quality. Non-reconstructable tendon defects. After tendon reconstruction the graft is shuttled and fixed on the cuff with two medially placed pulling sutures. With two lateral sutures the graft is pulled laterally over the reconstructed cuff and on the lateral tuberculum majus. Immobilization in an abduction pillow for 6 weeks with passive motion, active motion the next 6 weeks, and weight bearing after 12 weeks. Eight patients with a reconstructable re-rupture were augmented with an ECM patch. Short-term results after 6 months showed 5 (62.5%) healed tendons, 1 complete (12.5%) and 2 incomplete re-ruptures (25%). The CS (Constant Score) and SSV (Subjective Shoulder Value) were improved from 51 to 57% and 51 to 71%, which was not significant (p > 0.05). The Oxford shoulder score improved significantly from 21 to 38 (p < 0.05). There were no relevant intra- or postoperative complications.