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Updated: Oct 21, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
[Effectiveness of arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft for
Kai Huang1, Xuancheng Zhang1, Guoming Xie1
1Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, P. R. China.
Objective:
To evaluate effectiveness of arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft in treatment of irreparable massive rotator cuff tears (IMRCT).
Methods:
A retrospective case series study was conducted on 32 patients with IMRCT treated between July 2022 and December 2023. All patients underwent arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous peroneus longus tendon graft. There were 11 males and 21 females, aged 49-76 years (mean, 65 years). The clinical symptoms were joint pain accompanied by limited mobility and abduction weakness. The duration of preoperative symptoms ranged from 3 to 24 months (mean, 9 months). Pain was assessed using the visual analogue scale (VAS) score, and shoulder function was evaluated using the modified University of California at Los Angeles (UCLA) score and the Constant-Murley score before operation and at 3, 6, 12 months after operation. MRI was performed during follow-up to assess graft integrity. Complications were recorded.
Results:
The operation time ranged from 75 to 130 minutes, with a mean of 90 minutes. All incisions healed by first intention, and no significant complication or adverse reaction was observed. All patients were followed up 12-24 months (mean, 16.5 months). All postoperative scores improved significantly when compared with preoperative values ( P<0.05). Pain and function continued to improve over time; no significant difference was observed in the modified UCLA scores among 6 months, 12 months, and last follow-up, nor in any scores between 12 months and last follow-up ( P>0.05); all other pairwise comparisons showed significant differences ( P<0.05). At last follow-up, shoulder function was rated as excellent in 12 cases, good in 18 cases, and poor in 2 cases according to the modified UCLA scoring system, yielding an excellent-to-good rate of 93.8%. MRI follow-up demonstrated intact reconstructed rotator cuff structures in 29 patients, with a healing rate of 90.6% (29/32).
Conclusion:
Arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft is effective for IMRCT, significantly alleviating pain, improving shoulder range of motion, and restoring both functional and structural integrity, without major complication or adverse reaction.