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We considered the indications and limitations of repairing massive rotator cuff tears with a patch graft. There were 12 patients, 12 shoulders (male : 10, female : 2) who underwent patch with the long head of biceps (LHB) or tensor fascia lata. LHB patch was performed on three patients, tensor fascia lata patch on five, and tensor fascia lata patch with teres minor transfer on four. Average follow-up period was 21 months (6 to 33 months). Preand post-operative JOA scores were evaluated, and the factors affecting the JOA score were examined. Their JOA score significantly increased form a preoperative average of 58.6 points to postoperative average of 80.5 points. Postoperative re-tear was found in three patients with LHB patch and one patient with tensor fascia lata patch. As LHB patch was torn again in all three patients, it is necessary to reconsider the surgical technique for inserting the LHB patch. After surgery, there was no re-tear of the rotator cuff and no decrease in external rotator strength in teres minor transfer. Teres minor transfer is thus a good method for patients requiring large patch grafts.

Indications and Limitations of Patch Graft for Massive Rotator Cuff Tear