Use of Gracile and semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

Abstract Background Irreparable rotator cuff tears are common and difficult to treat. Techniques for “filling the loss of substance” require fixation stump (tendon augmentation) or glenoid (superior capsular reconstruction), which complicated by narrow working zone subacromial space. The main objective this study was determine whether a braided graft gracilis (GR) semitendinosus (ST) could fill tendon substance from an irreparable rupture supra- infraspinatus, fixing greater tuberosity spine scapula. Methods This cadaveric with use ten specimens. GRA ST tendons were harvested, reinforced suture. An experimental tear supraspinatus (SS) upper infraspinatus (IS) retracted at made. GRAST transplant positioned over tear. attached two anchors then medial third scapular trans-osseous stitching. percentage filling obtained measured passive mobility shoulder assessed. We proceeded same technique under arthroscopy 73 years old patient whom we treated painful inserted using arthroscopy. Results Braided-GRAST allowed 100% substance. Mobility complete in all cases. Conclusion simplifies restores musculo-tendinous chain where current grafting techniques only tendinous defect. have “spacer” effect lower humeral head. donor site morbidity fate in-vivo limits be discussed. anatomical paves way clinical experimentation.