Postoperative outcomes of modified graft augmentation for large to massive rotator cuff tears

The re-tear rate after rotator cuff repair for large to massive tears remains high, and improving postoperative outcomes is a clinical challenge. This study aimed to evaluate the clinical and radiological outcomes of a modified graft augmentation (GA) technique using a double suture bridge configuration. Thirty patients with large to massive rotator cuff tears who underwent the modified GA procedure after February 2017 and were followed for at least 2 years were included in this study. Preoperative and postoperative Japanese Orthopedic Association scores, University of California at Los Angeles scores, range of motion, muscle strength, acromiohumeral distance, and cuff integrity, assessed via magnetic resonance imaging using the Sugaya classification, were evaluated. Subgroup analyses were performed according to the presence or absence of pseudoparalytic shoulder. All clinical parameters showed significant improvement at 2 years postoperatively compared with preoperative values. Postoperative magnetic resonance imaging demonstrated maintained cuff integrity, with no re-tears observed at the final evaluation. There were no statistically significant differences in postoperative outcomes between patients with and without a pseudoparalytic shoulder. The modified GA technique using a double suture bridge configuration demonstrated favorable clinical outcomes and maintained structural integrity in patients with large to massive rotator cuff tears.