Deltoidplasty: Outcomes using orthobiologic augmentation

Iatrogenic deltoid injury can result in severe shoulder dysfunction and pain. We used an augmentation patch (porcine submucosa) concomitantly to assist in deltoid repair. We prospectively studied 14 patients (mean age, 57.9 years). All underwent deltoidplasty for postoperative deltoid dehiscence with the orthobiologic patch placed around the detached deltoid and subsequent transosseous repair to the acromion (mean follow-up, 30 months [range, 24-62 months]). Ten patients underwent concomitant revision rotator cuff repair. All patients had undergone at least 1 previous operation. All improved postoperatively with regard to pain, function, or both. The mean pain level (out of 10) decreased (from 5.4 to 1.2); strength (out of 5) improved (from 3.2 to 4.4), forward elevation increased (from 93.1° to 132.5°), external rotation improved (from 30.8° to 54.3°), and internal rotation improved (from L1 to T9). Improvements were found for the mean Simple Shoulder Test score (out of 12) (from 3.6 to 7.1), Disabilities of the Arm, Shoulder and Hand score (from 68.8 to 28.8), and American Shoulder and Elbow Surgeons score (from 38.3 to 69.4). Recurrent deltoid dehiscence occurred in 2 patients (14%). Deltoid dehiscence remains an unsolved issue associated with shoulder reconstruction. Augmenting deltoid repair can improve function and diminishes pain after failed rotator cuff surgery. Careful revision surgical technique and rehabilitation might provide quality outcomes in this patient population.