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

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.