Clinical investigation on the efficacy of modified Mason-Allen in healing delaminated rotator cuff tears

Abstract

Abstract Purpose To evaluate the arthroscopic modified Mason-Allen (mMA) suture technique's clinical effectiveness and safety in treating delaminated rotator cuff injuries. Methods Collected 62 patients with delaminated rotator cuff tears repaired using arthroscopic modified Mason-Allen suture technique from May 2022 to June 2023, including 21 males and 41 females; age ranged from 50 to 81 years old, with a median age of 65 years old; 34 cases in the left shoulder and 28 cases in the right shoulder; 30 cases with a history of trauma and 32 cases with no obvious history of trauma; According to the Cofield classification of rotator cuff tears, all were delaminated tears of the rotator cuff (1 to 3 cm). We recorded changes in shoulder joint range of motion (ROM) and functional ratings from 3 to 6 months following surgery, with a median of 6 months. Follow-up visits were undertaken to assess tendon-bone healing, improvement of shoulder discomfort, recovery of shoulder joint function, and incidence of problems. Results All patients were followed up for 3 to 6 months, with a median of 6 months. The MRI demonstrated excellent tendon-bone healing in all patients at the last follow-up. Shoulder anterior flexion supination improved from 98.06°±11.28°to 169.05° ± 9.05°, abduction supination improved from 69.68°±18.55°to 147.86°± 11.16°, internal rotation improved from 14.52°±10.35°to 47.62°± 6.91°, and external rotation improved from 22.42°±8.62°to 49.76°±6.04°; Constant-Murely score, preoperative (49.08 ± 4.91) and at the last follow-up (93.33 ± 4.95); and UCLA shoulder score, preoperative (15.73 ± 2.60) and at the last follow-up (33.55 ± 1.53). The change was statistically significant when comparing the data before and after surgery (P < 0.001). Eight patients acquired frozen shoulder symptoms after surgery owing to inconsistent rehabilitation activities, and the symptoms resolved after standardized rehabilitation exercises. All patients did not experience issues such as rotator cuff re-tear and anchor nail removal. Conclusion Repair with arthroscopic modified Mason-Allen suture technique can restore the wholeness and integrity of the delaminated rotator cuff, which can effectively alleviate shoulder joint pain, help early exercise, prevent and control further rotator cuff tear, enhance the initial strength of the rotator cuff as a whole, and improve the joint function of patients. Level of evidence III.