Retears and complication rates after arthroscopic rotator cuff repair with scaffolds: a systematic review

Abstract

The goal of repairing rotator cuff injuries is an anatomical procedure without tension repair. Considering the high percentage of re-rupture after large and massive lesions repair, numerous surgical solutions have been proposed. The purpose of this systematic review was to present retears and complication rates following arthroscopic treatment of rotator cuff pathology with scaffolds. A systematic review of the existing literature was performed to identify all studies dealing with arthroscopic rotator cuff repair using scaffolds. Two independent investigators performed the research using MEDLINE, Scopus, Embase and Cochrane Databases (1950 to January 2018). The search terms used were "arthroscopic" OR "arthroscopy" AND "rotator cuff" AND "augmentation" OR "scaffold" OR "patch" OR "matrix" OR "xenograft" OR "allograft" OR "autograft". A total of 10 articles met our inclusion criteria. Mean age at surgery was 61.92 years and size lesion ranged from small-intermediate lesion (3-6 mm) to irreparable/massive lesion. In 19 (10.67%) cases surgery was performed on recurrent rotator cuff repair with failed previous repair. Mean follow-up was 24.70 months. On 178 shoulders repaired, 32 (17.97%) reported a retear. As regards complications rate a total of 18 (10.11%) were noted. In conclusion, this review shows arthroscopic rotator cuff repair with scaffold can be considered an effective and safe treatment particularly for large or masive rotator cuff lesions, potentially able to provide clinical improvement.

Keywords: Arthroscopy; Augmentation; Autograft; Graft; Massive lesion; Patch; Rotator cuff; Scaffold; Xenograft.