Clinical outcomes and ultrasonographic viability of GraftJacket® augmented rotator cuff repair: a prospective follow-up study with mean follow-up of forty-one months

Simon M. Johnson, Jennifer V. Cherry, Naveena Thomas, Mansoor Jafri, Arpit Jariwala, Gordon G. McLeod

Research output: Contribution to journalArticle

Abstract

Background: The management of large rotator cuff tears in patients without evidence of glenohumeral arthritis is challenging and controversial. We wished to investigate the viability of Graft Jacket® augmentation and assess the clinical and radiological outcomes in a prospective study with a select cohort of patients. Methods: All procedures were performed by a single shoulder surgeon over a three-year period. Inclusion criteria were patients with large cuff tears (size 3–5 cm) not amenable to end-to-end repair. Patients with radiographic evidence of glenohumeral arthritis or cuff tear arthropathy were excluded. Open rotator cuff repair followed by bridging with GraftJacket® Regenerative Tissue Matrix was performed. Outcome was assessed with Constant scores (CS), QuickDash (QD) and Oxford Shoulder scores (OSS) at minimum twenty-two months and ultrasound assessment at nine months post-operatively. Results: Thirteen patients were identified who fit inclusion criteria (one bilateral). No patients were lost to follow up. At final follow-up thirteen shoulders had achieved function range of movement. Mean CS was 83 (range 70–100), mean Quick DASH was 5.4 (range 0–18.2), and mean OSS was 46 (range 41–48). Shoulder ultrasound revealed an intact Graft Jacket® in these patients. One patient had lower functional movement and worse CS (34), QD (34.1) and OSS (25) and ultrasound assessment identified a re-rupture. Discussion: This study indicates that augmentation of large rotator cuff repairs with a GraftJacket® scaffold is a viable option and has good functional results and sustained viability. Level of evidence: Level 4.

Original languageEnglish
JournalJournal of Clinical Orthopaedics and Trauma
Early online date6 Sep 2019
DOIs
Publication statusE-pub ahead of print - 6 Sep 2019

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Rotator Cuff
Arthritis
Transplants
Lost to Follow-Up
Tears
Rupture
Prospective Studies

Keywords

  • Biological scaffold
  • Cuff repair
  • GraftJacket®
  • Massive tear
  • Shoulder

Cite this

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title = "Clinical outcomes and ultrasonographic viability of GraftJacket{\circledR} augmented rotator cuff repair: a prospective follow-up study with mean follow-up of forty-one months",
abstract = "Background: The management of large rotator cuff tears in patients without evidence of glenohumeral arthritis is challenging and controversial. We wished to investigate the viability of Graft Jacket{\circledR} augmentation and assess the clinical and radiological outcomes in a prospective study with a select cohort of patients. Methods: All procedures were performed by a single shoulder surgeon over a three-year period. Inclusion criteria were patients with large cuff tears (size 3–5 cm) not amenable to end-to-end repair. Patients with radiographic evidence of glenohumeral arthritis or cuff tear arthropathy were excluded. Open rotator cuff repair followed by bridging with GraftJacket{\circledR} Regenerative Tissue Matrix was performed. Outcome was assessed with Constant scores (CS), QuickDash (QD) and Oxford Shoulder scores (OSS) at minimum twenty-two months and ultrasound assessment at nine months post-operatively. Results: Thirteen patients were identified who fit inclusion criteria (one bilateral). No patients were lost to follow up. At final follow-up thirteen shoulders had achieved function range of movement. Mean CS was 83 (range 70–100), mean Quick DASH was 5.4 (range 0–18.2), and mean OSS was 46 (range 41–48). Shoulder ultrasound revealed an intact Graft Jacket{\circledR} in these patients. One patient had lower functional movement and worse CS (34), QD (34.1) and OSS (25) and ultrasound assessment identified a re-rupture. Discussion: This study indicates that augmentation of large rotator cuff repairs with a GraftJacket{\circledR} scaffold is a viable option and has good functional results and sustained viability. Level of evidence: Level 4.",
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Clinical outcomes and ultrasonographic viability of GraftJacket® augmented rotator cuff repair : a prospective follow-up study with mean follow-up of forty-one months. / Johnson, Simon M.; Cherry, Jennifer V.; Thomas, Naveena; Jafri, Mansoor; Jariwala, Arpit; McLeod, Gordon G.

In: Journal of Clinical Orthopaedics and Trauma, 06.09.2019.

Research output: Contribution to journalArticle

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T1 - Clinical outcomes and ultrasonographic viability of GraftJacket® augmented rotator cuff repair

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AU - Cherry, Jennifer V.

AU - Thomas, Naveena

AU - Jafri, Mansoor

AU - Jariwala, Arpit

AU - McLeod, Gordon G.

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AB - Background: The management of large rotator cuff tears in patients without evidence of glenohumeral arthritis is challenging and controversial. We wished to investigate the viability of Graft Jacket® augmentation and assess the clinical and radiological outcomes in a prospective study with a select cohort of patients. Methods: All procedures were performed by a single shoulder surgeon over a three-year period. Inclusion criteria were patients with large cuff tears (size 3–5 cm) not amenable to end-to-end repair. Patients with radiographic evidence of glenohumeral arthritis or cuff tear arthropathy were excluded. Open rotator cuff repair followed by bridging with GraftJacket® Regenerative Tissue Matrix was performed. Outcome was assessed with Constant scores (CS), QuickDash (QD) and Oxford Shoulder scores (OSS) at minimum twenty-two months and ultrasound assessment at nine months post-operatively. Results: Thirteen patients were identified who fit inclusion criteria (one bilateral). No patients were lost to follow up. At final follow-up thirteen shoulders had achieved function range of movement. Mean CS was 83 (range 70–100), mean Quick DASH was 5.4 (range 0–18.2), and mean OSS was 46 (range 41–48). Shoulder ultrasound revealed an intact Graft Jacket® in these patients. One patient had lower functional movement and worse CS (34), QD (34.1) and OSS (25) and ultrasound assessment identified a re-rupture. Discussion: This study indicates that augmentation of large rotator cuff repairs with a GraftJacket® scaffold is a viable option and has good functional results and sustained viability. Level of evidence: Level 4.

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