Treatment of massive rotator-cuff tears with a polyester ligament (LARS) patch

Published online: Dec 27 2013

Michael J. PETRIE, A. Hany ISMAIEL

From Barnsley Hospital NHS Foundation Trust, Barnsley, South Yorkshire, UK


We describe and analyse the results of our technique for repairing chronic massive tears (Goutallier grade 3 or 4) of the rotator cuff using a ligament augmentation and reconstruction system. This prospective, single surgeon series included 29 symptomatic patients (21 male, 8 female) with a mean age of 67.1 years who underwent 31 ligament augmentation and reconstruction system procedures (two bilateral procedures) with a mean follow-up period of 3 years. All patients had clinical, radiographic, magnetic resonance imaging and arthroscopic evidence of a chronic massive rotator cuff tear. The primary outcome measure was assessed using the Oxford Shoulder Score and visual analogue score pre-operatively and at follow-up. Postoperative overall Oxford shoulder score and visual analogue score results demonstrated a statistically significant improvement at follow-up, compared with pre-operative values (p < 0.0001). Post-operative acromio-humeral interval showed a statistically significant increase when compared to pre-operative radiographs (p = 0.0004). Two patients required revision with good postoperative results. We believe that, in the appropriate age group, the ligament augmentation and reconstruction system repair offers a good option for chronic, primary, non-closable rotator cuff defects in terms of pain relief and function.