The Use of Autologous Iliotibial Band With Gerdy's Tubercle for Irreparable Rotator Cuff Tears

Abstract

Objective: To determine the radiographic and functional outcomes after autologous iliotibial band with Gerdy's tubercle (ITB-GT) interposition in patients with irreparable rotator cuff tears (IRCTs). Methods: From December 2015 to March 2017, a total of 16 patients who underwent autologous ITB-GT interposition for IRCTs were identified, including 4 males and 12 females. The mean age was 56.1 ± 10.3 years (range, 44–67 years). Functional assessment consisted of active range of motion (ROM), Visual Analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score, and patient satisfaction rate. The tendon integrity and acromiohumeral interval (AHI) were assessed by postoperative magnetic resonance imaging (MRI). Results: The mean duration of follow-up was 25.3 ± 3.5 months. At final follow-up, the patients exhibited significantly improved forward elevation, external rotation, and internal rotation (75.00° ± 13.16° to 159.37° ± 8.51°, t = 26.71, P = 0.001; 17.81° ± 11.54° to 35.31° ± 8.26°, t = 6.57, P = 0.001; 2 to 11, t = 13.10, P = 0.001). Other functional outcomes as measured by VAS score, ASES score, and Constant–Murley score also improved significantly (6.50 ± 1.41 to 1.06 ± 0.93, t = 11.68, P = 0.001; 38.50 ± 8.68 to 81.75 ± 6.80, t = 15.42, P = 0.001; 32.50 ± 8.53 to 77.12 ± 6.72, t = 17.28, P = 0.001). The overall satisfaction rate was 87.5%. The postoperative MRI showed that the tendon integrity was fully intact in 14 patients and partially intact in two patients. The AHI improved significantly from 3.63 ± 1.25 mm preoperatively to 8.37 ± 1.02 mm postoperatively (t = 11.78, P = 0.001). Conclusion: Autologous ITB-GT interposition was a useful treatment option for patients with IRCTs, which resulted in significant improvements in active ROM, subjective functional outcomes, and AHI with excellent tendon integrity at a minimum 2-year follow-up.