Augmentation with a Gore-Tex patch for repair of large rotator cuff tears that cannot be sutured

The objective of this study was to determine the effectiveness of augmentation with a Gore-Tex patch in reconstruction of rotator cuff tears that cannot be repaired by direct suture. Twenty-eight shoulders of 27 patients underwent this procedure. The average age at surgery was 62 years, the average duration of symptoms before surgery was 16 months, and the average follow-up period was 44 months. The shoulders were classified into two groups according to patch size (anteroposterior dimension up to 2 cm or greater than 2 cm). The clinical outcome was evaluated by using the shoulder surgery classification system issued by the Japanese Orthopaedic Association (JOA score), and the postoperative isometric abduction strength at 90 degrees of abduction was assessed by the method of Constant. The average total JOA score improved from 57.7 to 88.7 points, a statistically significant change. There was no difference in the improvement in score between shoulders treated with small patches (12 shoulders) and those treated with large patches (16 shoulders). The average abduction strength was 6.2 kg in the small-patch group and 1.5 kg in the large-patch group, with a statistically significant difference between the two groups. Good clinical results, especially pain relief, could be achieved with this procedure in both the small- and the large-patch groups, but good abduction strength was obtained only in the small-patch group. The mechanism of the improvement by this procedure is still controversial.