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Deltoidplasty: outcomes using orthobiologic augmentation
Caroline M Chebli1, Anand M Murthi
1Shoulder and Elbow Service, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21207, USA.
Journal of Shoulder and Elbow Surgery
|March 21, 2007
Summary
This study shows that using a porcine submucosa patch to augment deltoid repair significantly reduces pain and improves shoulder function in patients with iatrogenic deltoid injury. These findings offer a promising solution for persistent deltoid dehiscence after shoulder surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Regenerative Medicine
Background:
- Iatrogenic deltoid injury can lead to significant shoulder dysfunction and pain, often occurring after complex shoulder reconstructions.
- Deltoid dehiscence, a tear in the deltoid muscle, presents a challenging complication in revision shoulder surgery, with limited effective treatment options.
Purpose of the Study:
- To evaluate the efficacy of an orthobiologic augmentation patch (porcine submucosa) in conjunction with surgical repair for iatrogenic deltoid dehiscence.
- To assess the impact of this combined approach on patient pain, shoulder function, and range of motion.
Main Methods:
- A prospective study of 14 patients who underwent deltoidplasty with a porcine submucosa patch and transosseous repair for postoperative deltoid dehiscence.
- Patients had a mean follow-up of 30 months; 10 patients also had concurrent revision rotator cuff repair.
- All patients had prior shoulder surgery history.
Main Results:
- Significant improvements were observed in pain reduction (mean pain score decreased from 5.4 to 1.2), shoulder strength (3.2 to 4.4), and range of motion (forward elevation, external rotation, internal rotation).
- Patient-reported outcomes improved, with notable increases in Simple Shoulder Test, Disabilities of the Arm, Shoulder and Hand (DASH), and American Shoulder and Elbow Surgeons (ASES) scores.
- Recurrent deltoid dehiscence occurred in 2 patients (14%).
Conclusions:
- Augmentation of deltoid repair with a porcine submucosa patch can effectively improve function and decrease pain in patients experiencing deltoid dehiscence after shoulder reconstruction.
- While deltoid dehiscence remains a challenge, this technique offers a viable option for managing this complication, potentially improving outcomes in complex revision cases.