Subacromial Implantation of Autologous Fascia Lata Spacer for the Treatment of Irreparable Massive Rotator Cuff Tears

Lu Mingfeng; Li Shilin; Zhao Lilian; Gao Junqing; He Lilei; Wang Changbing; Xing Jisi

Abstract：Objective To evaluate the clinical efficacy of arthroscopic subacromial autologous fascia lata spacer implantation for treating irreparable massive rotator cuff tears.Methods A retrospective analysis was conducted on 16 patients treated with arthroscopic subacromial autologous fascia lata spacer implantation for irreparable massive rotator cuff tears in Foshan Hospital of Traditional Chinese Medicine from December 2019 to March 2023.The cohort included 13 males and 3 females,aged between 58 and 68 years,with an average age of(61.91±3.92)years.Ten cases involved the right shoulder and six the left,with ten cases affecting the dominant side.The duration of preoperative symptoms ranged from 2 to 50 months,averaging(15.02±12.53)months,and six patients had a history of trauma.All cases were primary surgeries.Postoperative assessments included shoulder range of motion,visual analogue scale(VAS)for pain,American shoulder and elbow surgeons(ASES)score,University of California Los Angeles(UCLA)score,and Constant-Murley score to evaluate shoulder function.Results The follow-up period ranged from 24 to 63 months,with an average of(43.51±19.50)months.There were no complications such as fever,infection,joint adhesion,or neurological dysfunction.At the final follow-up,the average acromiohumeral distance(AHD)increased significantly from(5.42±1.10)mm preoperatively to(7.03±0.64)mm.Improvements in active range of motion for flexion,abduction,lateral external rotation,and external rotation at 90 ° abduction were significant,increasing from(98.21±40.42)°,(70.65±14.42)°,(19.33±11.51)°,and(13.57±8.23)° preoperatively to(130.52±23.64)°,(94.62±9.37)°,(42.40±11.76)°,and(55.43±15.86)° respectively(P＜0.05).The final VAS score decreased significantly from(7.45±2.34)preoperatively to(1.82±0.91)(P＜0.01).The final ASES score was(93.64±5.82),UCLA score was(32.83±1.92),and Constant-Murley score was(86.72±6.55),all showing significant improvements from preoperative scores of(34.31±15.44),(10.81±5.23),and(34.57±14.91)respectively(P＜0.01).Two years postoperatively,9 patients were very satisfied,5 were satisfied,and 2 were dissatisfied.Conclusion Arthroscopic subacromial autologous fascia lata spacer implantation for irreparable massive rotator cuff tears achieves satisfactory clinical outcomes,significantly alleviating pain symptoms,improving joint mobility,and restoring joint function.