Clinical outcomes of iliotibial band with Gerdy's tubercle transplantation for irreparable rotator cuff tears / 中华骨科杂志

ABSTRACT

Objective To observe the early clinical outcomes of iliotibial band with Gerdy's tubercle transplantation for irreparable rotator cuff tears (IRCT).Methods A total of 16 patients with IRCT who underwent iliotibial band with Gerdy's tubercle transplantation from June 2014 to June 2015 and with a minimum follow-up of 2 years were retrospectively analyzed.There were 4 male and 12 female with a mean age of 56.1±6.6 years old (range 44-67 years old).The X-ray and MRI were used to evaluate the improvement of acromiohumeral interval (AHI),rotator cuff healing and final outcome of bone graft postoperatively.Functional outcomes were assessed by visual analogue scale (VAS),American Shoulder and Elbow Surgeon (ASES) and Constant-Murley score.Results The average follow-up duration was 25.3±1.5 months (range 24-48 months).At the final follow-up,the forward flexion,external rotation and internal rotation were 159.37°±8.51°,35.31°±8.26° and 11.00°±2.52°,respectively.There was statistically significant difference between preoperative and postoperative joint range of motion (P ＜ 0.05).At the 3 months postoperatively,all patients had complete bone union between the Gerdy's tubercle and the greater tubercle.However,at the final followup,partial or complete bone absorption was observed in 6 patients.Twelve patients had complete rotator cuff healing,and 4 patients had partial healing.No patient had rotator cuff retear.The AHI increased significantly from 3.63±1.25 mm preoperatively to 8.37± 1.02 mm postoperatively (P ＜ 0.05).The postoperative VAS,ASES and Constant-Murley score were 1.06±0.93,81.75±6.80 and 77.12± 6.72,respectively.The differences between preoperative and postoperative VAS,ASES and Constant-Murley score were statistically significant (P ＜ 0.05).There was significant difference in postoperative VAS between bone absorption group and non-absorption group (P ＜ 0.05),while no significant difference was found in ASES or Constant-Murley score (P ＞ 0.05).Conclusion All patients had complete or partial rotator cuff healing.However,37.5％ of the patients had bone absorption and obtained a worse VAS score.The iliotibial band with Gerdy's tubercle transplantation for IRCT could significantly restore the joint function at 2 years postoperatively.