Kang Hyunseong, Yoo Seung Jin, Yang Joseph, Lee Kyung Ryeol, Choi Sungwook
Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea.
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Orthop Surg Res. 2025 Mar 22;20(1):304. doi: 10.1186/s13018-025-05696-1.
Allogenous dermal scaffold augmentation enhances partial rotator cuff repairs by providing structural support and a biologic scaffold that promotes tissue regeneration, reduces mechanical strain, and compensates for poor tendon quality in large to massive rotator cuff tears. This approach helps lower the risk of retear and improves functional recovery.
This study included 55 patients with large to massive rotator cuff tears, divided into two groups. Group A (28 patients) underwent arthroscopic partial repair, while Group B (27 patients) received allogenous dermal scaffold graft augmentation following partial repair to reinforce the repair and resurface the uncovered tendon footprint. Clinical assessments, including the University of California-Los Angeles score, Constant-Murley score, and visual analogue scale, were conducted preoperatively, at 3, 6, and 12 months postoperatively, and annually thereafter. Radiologic evaluations, including magnetic resonance imaging and ultrasonography, were performed preoperatively and postoperatively to assess tendon integrity.
The mean follow-up period was 40 months for Group A and 36 months for Group B. Clinical functional scores significantly improved in both groups at the final follow-up. Postoperative radiologic assessment showed 9 retears in Group A and 4 in Group B (p < 0.05), respectively, with significantly greater postoperative tendon thickness in Group B compared to Group A (p-value < 0.05). Additionally, acromiohumeral distance improved significantly in both groups, from 7 mm to 9 mm in Group A and from 7 mm to 11 mm in Group B, with Group B demonstrating superior improvement (p < 0.01).
This study suggests that allogenous dermal scaffold graft augmentation, in addition to partial repair, enhances tendon thickness and acromiohumeral distance. Furthermore, it results in lower retear rates compared to partial repair alone.
异体真皮支架增强术通过提供结构支撑和促进组织再生的生物支架，减少机械应变，并弥补大至巨大肩袖撕裂中肌腱质量差的问题，从而增强部分肩袖修复效果。这种方法有助于降低再次撕裂的风险并改善功能恢复。
本研究纳入55例大至巨大肩袖撕裂患者，分为两组。A组（28例患者）接受关节镜下部分修复，而B组（27例患者）在部分修复后接受异体真皮支架移植增强术，以加强修复并覆盖未覆盖的肌腱足迹。术前、术后3个月、6个月和12个月以及此后每年进行临床评估，包括加利福尼亚大学洛杉矶分校评分、Constant-Murley评分和视觉模拟量表。术前和术后进行放射学评估，包括磁共振成像和超声检查，以评估肌腱完整性。
A组平均随访期为40个月，B组为36个月。两组在最终随访时临床功能评分均显著改善。术后放射学评估显示，A组有9例再次撕裂，B组有4例（p < 0.05），B组术后肌腱厚度显著大于A组（p值 < 0.05）。此外，两组肩峰下间隙均显著改善，A组从7毫米改善至9毫米，B组从7毫米改善至11毫米，B组改善更显著（p < 0.01）。
本研究表明，异体真皮支架移植增强术除部分修复外，还能增加肌腱厚度和肩峰下间隙。此外，与单纯部分修复相比，其再次撕裂率更低。
