Use of Graft Jacket as an Augmentation for Massive Rotator Cuff Tears

Tendon healing and improved strength in the face of massive rotator cuff tear repair remains a daunting challenge. Seventeen consecutive patients with massive rotator cuff tears were treated with a standardized open repair technique and the repair augmented with Graft Jacket (Wright Medical, Memphis, Tennessee). Mean follow-up was 1.2 years (438 days). Pain scores improved with 11 patients (64%) reporting no pain or occasional and slight pain. Functional status improved with 12 patients (70%) reporting normal function or slight restriction only. Active forward flexion improved with 10 patients (59%) having greater than 150°. UCLA scores improved significantly from a mean 9.06 preoperatively to 26.12 (P value < 0.001). Three recurrent tears were observed on 11 available postoperative MRI scans and one CT arthrogram. The recurrent tears were smaller than preop MRI scans and 2 of 3 patients were satisfied with surgery. There was no change in muscle trophicity. No other complications were observed, including no infections or sterile inflammatory reactions. Open repair of massive rotator cuff tears with Graft Jacket augmentation appears to be an effective and safe treatment option. Our surgical technique is described as well as the early results.