Due to the impact of chronic course, irreparable rotator cuff tears often have remarkable rotator cuff retraction, muscle atrophy and fatty filtration. It is difficult to realize the in-situ repair of reducing rotator cuff to footprint area for conventional operation methods with high incidence of postoperative re-tear and poor functional recovery, which is one big problem for shoulder joint surgeons. Currently, there is no universally accepted ideal and exact treatment plan. Patch bridging is one of the treatment options for irreparable rotator cuff tear with satisfactory short-term clinical results.

To investigate the early curative efficacy of arthroscopic bridging reconstruction using fascia lata patch autograft for irreparable rotator cuff tears and the structural integrity of patch.

From January 2019 to December 2019, 12 patients (6 males and 6 females) of irreparable rotator cuff tears were treated with arthroscopic bridging reconstruction using fascia lata patch autograft and the data were retrospectively analyzed. Their ages ranged from 49 to 80 year with an average age of (66.1±8.6) years. The duration of preoperative symptoms was 34.8 months (1 to 120 months) . Hamada classification was used with standard anteroposterior radiographs of glenohumeral joint preoperatively. The ranges of motion (anteflexion, abduction and external rotation) were recorded before and after operation. All patients were evaluated using the visual analogue scale (VAS) , American shoulder and elbow surgeons (ASES) , Constant-Murley score, and University of California Los Angeles (UCLA) score. The structural integrity of patch was assessed using the magnetic resonance imaging (MRI) .

All the incisions were primary healing without complications or adverse reactions. All patients were followed up for 9.5 to 20 months with a mean duration of (13.9±4.0) months. According to Hamada classification, there were 7 patients of Grade 2 and 5 patients of Grade 3. During the preoperative and last follow ups, the ranges of anteflexion were 108.3°±36.9° and 162.5°±9.9° respectively, the ranges of abduction were 69.6°±13.8° and 94.6°±9.5° respectively, the rages of external rotation were 20.8°±11.3° and 43.8°±12.3° respectively, the VAS scores were (7.1±0.6) points and (0.9±0.6) points respectively, the UCLA scores were (11.8±2.2) points and (31.3±2.0) points respectively, the ASES scores were (42.2±8.1) points and (90.0±5.0) points respectively, and the Constant-Murley scores were (46.7±8.5) points and (85.8±7.5) points respectively. There were significant differences in the ROM of forward flexion, abduction and external rotation, VAS scores, UCLA scores, ASES scores and Constant-Murley scores (P<0.001) . According to the UCLA scores in the last follow up, there were 2 excellent cases, 9 good cases and 1 poor case, and the excellent and good rate was 91.7% (11/12) . All the bridging patches were intact based on MRI results.

Arthroscopic bridging reconstruction with fascia lata patch autograft for irreparable rotator cuff tears can relieve pain, improve postoperative ROM and achieve functional recovery without structural failures of bridging patch.