Early Clinical Study on Shoulder Arthroscopy Using Fascia Lata Patch Bridging for the Repair and Reconstruction of Massive Irreparable Rotator Cuff Tears

Chen Lihuan; Wen Dan; Gong Xuyong; Dai Xiaomei; Liu Wenkang; Yang Yuxia; Fei Wenyong

Abstract：Objective To investigate the early clinical effectiveness of shoulder arthroscopy using a fascia lata patch for repair and reconstruction in the treatment of massive irreparable rotator cuff tears.Methods We conducted a retrospective analysis of 23 patients who underwent arthroscopic repair using a fascia lata patch for massive irreparable rotator cuff tears at northern Jiangsu people's hospital between January 2019 and August 2023.The cohort included 9 men and 14 women,with an age range of 53 to 80 years[mean(65.9±6.9)years].We compared preoperative and postoperative metrics,including active forward flexion,abduction,external and internal rotation,pain levels using the visual analogue scale(VAS),the American shoulder and elbow surgeons(ASES)score,and the Constant-Murley score.MRI images from the final follow-up were used to assess patch healing.Additionally,we measured and compared the shoulder-humerus distance,the occupancy rate of the supraspinatus muscle,the ratio of abduction muscle strength between the affected and healthy sides,and the Goutallier classification of the affected shoulder to evaluate the degree of patch deformation and improvement in supraspinatus muscle atrophy.Results Patients were followed up for 16 to 42 months,with a mean follow-up duration of(26.4±7.6)months.At the final follow-up,significant improvements were observed in active forward flexion,abduction,external rotation,internal rotation,VAS,ASES score,Constant-Murley score,shoulder-humerus distance,occupancy rate of the supraspinatus muscle,ratio of abduction muscle strength between the affected and healthy sides,and Goutallier classification of the affected shoulder compared to preoperative measurements(P＜0.05).At the final follow-up,21 patches achieved complete healing,with a healing rate of 91.3％.Conclusion Arthroscopic repair using a fascia lata patch for massive irreparable rotator cuff tears effectively restores shoulder function,reduces fat infiltration in the supraspinatus muscle,and minimizes patch deformation and elongation.This technique warrants further investigation.