Radiological and clinical evaluation of synthetic reinforcement in arthroscopic repair of complete degenerative rotator cuff tears

BACKGROUND: Rotator cuff tear is the most common shoulder pathology in adults over 45 years of age. In most instances they are chronic and degenerative. The high rate of re- tears after primary repair has led to the use of reinforcement systems such as patches. The objective of this study was to evaluate the effectiveness of a synthetic poly-4-hydroxybutyrate (P4HB) reinforcement patch in arthroscopic repair of degenerative rotator cuff tears. METHODS: sixty patients with degenerative, reducible, full thickness supraspinatus tear were repaired with an arthroscopic single-row technique with or without the BioFiber® reinforcement system (Wright medical). A clinical evaluation with measurement of active range of motion, calculation of Constant and Subjective Shoulder Value (SSV) scores and ultrasound evaluation of healing were performed one year postoperatively. RESULTS: Thirty patients were treated with a patch and thirty others formed the control group without a patch. The postoperative adjusted Constant score was 102 % in the patch group (PG) and 101 % in the control group (CG) (P = 0.6670). The postoperative SSV score was 81% in the PG and 88% in the CG (P = 0.029). The ultrasound healing rate was better in the PG and there was no re-tear in this group (P = 0.049). CONCLUSION: The interposition of the P4HB BioFiber® patch does not seem to provide any added functional value despite the effectiveness in terms of healing in the repair of degenerative, reducible complete tear of the supraspinatus tendon.