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Rotator cuff augmentation

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https://www.readbyqxmd.com/read/29430398/revision-of-failed-rotator-cuff-reconstruction-with-a-large-humeral-head-cyst
#1
Bashar Reda, Catherine Coady, Ivan Wong
A revision rotator cuff repair is a technically challenging surgical procedure. This can be further complicated by the presence of poor quality of the cuff tissue, as well as a large greater tuberosity cyst, typically located at the rotator cuff footprint. This Technical Note discusses the surgical approach to deal with a revision rotator cuff tear with a large humeral head cyst. This described arthroscopic technique is performed in a single-stage procedure using a human dermal allograft (GraftJacket) for augmentation...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29411322/the-role-of-biologic-therapy-in-rotator-cuff-tears-and-repairs
#2
REVIEW
Michael D Charles, David R Christian, Brian J Cole
PURPOSE OF REVIEW: The purpose of this review was to establish the foundation of the major biologic adjuvants to rotator cuff repairs and review recent scientific findings. RECENT FINDINGS: Platelet-rich plasma (PRP) overall has no significant impact on functional outcomes and repair integrity, but may be more advantageous in small to medium tears. Further studies should focus on leukocyte-rich versus poor preparations and the use of PRP in patients that are high risk for repair failure...
February 7, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29398989/the-primary-stability-of-a-bioabsorbable-poly-l-lactic-acid-suture-anchor-for-rotator-cuff-repair-is-not-improved-with-polymethylmethacrylate-or-bioabsorbable-bone-cement-augmentation
#3
Mehmet F Güleçyüz, Michael Kraus-Petersen, Christian Schröder, Andreas Ficklscherer, Markus U Wagenhäuser, Christian Braun, Peter E Müller, Matthias F Pietschmann
Background: The incidence of osteoporosis and rotator cuff tears increases with age. Cement augmentation of bones is an established method in orthopedic and trauma surgery. Questions/Purposes: This study analyses if polymethylmethacrylate or bioabsorbable cement can improve the primary stability of a bioabsorbable suture anchor in vitro in comparison to a non-augmented suture anchor in osteoporotic human humeri. Methods: The trabecular bone mineral density was measured to ensure osteopenic human specimens...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29398399/augmentation-with-a-reinforced-acellular-fascia-lata-strip-graft-limits-cyclic-gapping-of-supraspinatus-repairs-in-a-human-cadaveric-model
#4
Ryan A Milks, Joel D Kolmodin, Eric T Ricchetti, Joseph P Iannotti, Kathleen A Derwin
BACKGROUND: A reinforced biologic strip graft was designed to mechanically augment the repair of rotator cuff tears that are fully reparable by arthroscopic techniques yet have a likelihood of failure. This study assessed the extent to which augmentation of human supraspinatus repairs with a reinforced fascia strip can reduce gap formation during in vitro cyclic loading. METHODS: The supraspinatus tendon was sharply released from the proximal humerus and repaired back to its insertion with anchors in 9 matched pairs of human cadaveric shoulders...
February 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29393349/enhancement-of-tendon%C3%A2-bone-healing-following-rotator-cuff-repair-using-hydroxyapatite-with-tgf%C3%AE-1
#5
Xiebo You, Yueqin Shen, Weihan Yu, Yaohua He
The formation of fibrocartilage at the healing site following a rotator cuff tear repair is a major problem in the field of tendon‑bone healing. The present study aimed to enhance the healing of the tendon‑bone interface following rotator‑cuff tear repair by the interposition of hydroxyapatite (HA) encapsulated with transforming growth factor β1 (TGFβ1). Using an acute rotator cuff repair model, rats were divided into three groups: i) Repair only (control); ii) HA group; and iii) HA‑TGFβ1 group...
January 26, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29373293/biceps-autograft-augmentation-for-rotator-cuff-repair-a-systematic-review
#6
REVIEW
Egbert J D Veen, Martin Stevens, Ronald L Diercks
PURPOSE: To improve surgical outcomes in patients with massive cuff defects, different techniques and augmentations are proposed. The biceps tendon is easily available as an autograft. Our aim was to conduct a qualitative systematic review of various methods and surgical techniques that use a biceps autograft (BAG) for rotator cuff repair. Functional outcomes are also reported. We hypothesized that by using a BAG to treat massive rotator cuff tears, a more anatomic and biomechanical reconstruction could be achieved compared with other techniques...
January 17, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29362995/the-repaired-rotator-cuff-mri-and-ultrasound-evaluation
#7
REVIEW
Susan C Lee, Danielle Williams, Yoshimi Endo
PURPOSE OF REVIEW: The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications. RECENT FINDINGS: The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months...
January 24, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29354447/arthroscopic-superior-capsule-reconstruction-technique-in-the-setting-of-a-massive-irreparable-rotator-cuff-tear
#8
George Sanchez, William H Rossy, Kyle P Lavery, Kevin J McHale, Marcio B Ferrari, Anthony Sanchez, Matthew T Provencher
Massive, irreparable rotator cuff tears are challenging to treat and associated with pain and severe limitation in shoulder elevation due to the proximal migration of the humeral head and, consequently, subacromial impingement. Furthermore, retraction of the tendons in combination with fat infiltration and muscular weakness results in unpredictable treatment outcomes. While conservative treatment may be warranted for low-demand patients, surgical treatment is often indicated for a successful return to activities of daily living as well as an improved quality of life...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29352758/-arthroscopic-rotator-cuff-surgery-new-and-established-methods
#9
REVIEW
S Pauly, M Scheibel
This present article summarizes established and current developments and aspects of rotator cuff surgery. Achieved milestones as well as current approaches are presented and assessed with respect to their clinical and radiographic impact. Despite biomechanical and technical improvements in modern rotator cuff repair techniques, re-defect and re-tearing rates could not be fully eliminated. Meanwhile, the importance of biological processes around successful tendon-bone reintegration has been increasingly recognized...
January 19, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#10
Tobias Helfen, Georg Siebenbürger, Florian Haasters, Wolfgang Böcker, Ben Ockert
BACKGROUND: To identify the prevalence of concomitant glenohumeral injuries in surgically treated Neer type II distal clavicle fractures and relate its clinical importance. METHODS: Between 11/2011 and 11/2015 41 patients, suffering from a displaced and unstable distal clavicle fracture were included. 20 patients (group 1) received surgical treatment by means of plate osteosynthesis in combination with an arthroscopically assisted coraco-clavicular ligament augmentation...
January 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29328887/macroscopic-rotator-cuff-tendinopathy-and-histopathology-do-not-predict-repair-outcomes-of-rotator-cuff-tears
#11
Paul M Sethi, Chirag D Sheth, Leo Pauzenberger, Mary Beth R McCarthy, Mark P Cote, Emma Soneson, Seth Miller, Augustus D Mazzocca
BACKGROUND: Numerous studies have identified factors that may affect the chances of rotator cuff healing after surgery. Intraoperative tendon quality may be used to predict healing and to determine type of repair and/or consideration of augmentation. There are no data that correlate how gross tendon morphology and degree of tendinopathy affect patient outcome or postoperative tendon healing. Purpose/Hypothesis: The purposes of this study were to (1) compare the gross appearance of the tendon edge during arthroscopic rotator cuff repair with its histological degree of tendinopathy and (2) determine if gross appearance correlated with postoperative repair integrity...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29317260/growth-factor-delivery-strategies-for-rotator-cuff-repair-and-regeneration
#12
Anupama Prabhath, Varadraj N Vernekar, Enid Sanchez, Cato T Laurencin
The high incidence of degenerative tears and prevalence of retears (20-95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair...
January 6, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29304975/editorial-commentary-don-t-pig-out-when-selecting-a-shoulder-rotator-cuff-augmentation-graft-xenografts-are-not-the-way-to-go
#13
EDITORIAL
F Alan Barber
Porcine xenograft dermal onlay augmentation of rotator cuff repair does not provide improved cuff integrity or provide better clinical outcomes. The retear rate was actually higher in repairs augmented with a porcine xenograft than the control group. Adverse events occurred in 60% of the xenograft patients compared with 40% of the controls. The use of liquid platelet-rich plasma had no discernible impact. A total of 85% of the observed failures with the suture-bridging double-row repair were at the medial cuff (Cho type 2)...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29198938/outcomes-of-arthroscopic-revision-rotator-cuff-repair-with-acellular-human-dermal-matrix-allograft-augmentation
#14
Eric A Hohn, Blake P Gillette, Joseph P Burns
BACKGROUND: The purpose was to assess the minimum 2-year patient-reported outcomes and failure rate of patients who underwent revision arthroscopic rotator cuff repair augmented with acellular human dermal matrix (AHDM) allograft for repairable retears. METHODS: From 2008-2014, patients who underwent revision rotator cuff repair augmented with AHDM with greater than 2 years' follow-up by a single surgeon were retrospectively reviewed. Data regarding surgical history, demographic characteristics, and medical comorbidities were collected...
November 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29166217/the-radiologist-s-primer-to-imaging-the-noncuff-nonlabral-postoperative-shoulder
#15
Christopher R Smith, Jason T Yoon, Jeremiah R Long, Michael V Friedman, Travis J Hillen, James D Stensby
Many radiologists are familiar with the preoperative imaging assessment of patients with labral tears, rotator cuff abnormalities, and end-stage arthritis, as well as the subsequent primary reconstructions and repairs commonly encountered in routine clinical management. However, the second-line surgical procedures and augmentation procedures performed for refractory or recurrent shoulder instability and the extra-articular surgical procedures of the shoulder girdle may challenge even the most experienced musculoskeletal radiologist...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29127887/pullout-strength-of-cement-augmented-and-wide-suture-transosseous-fixation-in-the-greater-tuberosity
#16
Brendan Y Shi, Miguel Diaz, Stephen M Belkoff, Uma Srikumaran
BACKGROUND: Obtaining strong fixation in low-density bone is increasingly critical in surgical repair of rotator cuff tears because of the aging population. To evaluate two new methods of improving pullout strength of transosseous rotator cuff repair in low-density bone, we analyzed the effects of 1) using 2-mm suture tape instead of no. 2 suture and 2) augmenting the lateral tunnel with cement. METHODS: Eleven pairs of osteopenic or osteoporotic cadaveric humeri were identified by dual-energy x-ray absorptiometry...
November 2, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29124078/demineralized-bone-matrix-to-augment-tendon-bone-healing-a-systematic-review
#17
Adam T Hexter, Catherine Pendegrass, Fares Haddad, Gordon Blunn
Background: Following injury to the rotator cuff and anterior cruciate ligament, a direct enthesis is not regenerated, and healing occurs with biomechanically inferior fibrous tissue. Demineralized bone matrix (DBM) is a collagen scaffold that contains growth factors and is a promising biological material for tendon and ligament repair because it can regenerate a direct fibrocartilaginous insertion via endochondral ossification. Purpose: To provide a comprehensive review of the literature investigating the use of DBM to augment tendon-bone healing in tendon repair and anterior cruciate ligament reconstruction (ACLR)...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29063145/-humeral-and-glenoid-bone-loss-in-shoulder-arthroplasty-classification-and-treatment-principles
#18
REVIEW
F Gohlke, B Werner
TECHNIQUE: The treatment of bone defects in primary shoulder arthroplasty has evolved due to more detailed diagnostic tools, 3D planning and expanded indications for reverse shoulder arthroplasty. Glenoid bone defects combined with chronic posterior subluxation of the humeral head are gradually being treated by glenoid reconstruction and reverse implants even if the rotator cuff is still intact. The treatment of advanced bone loss due to glenoid loosening has been facilitated by bone augmentation using a cementless fixation as proposed by Norris...
October 23, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29059116/management-of-failed-rotator-cuff-repair-in-young-patients
#19
Bassem T Elhassan, Ryan M Cox, Dave R Shukla, Julia Lee, Anand M Murthi, Robert Z Tashjian, Joseph A Abboud
Management of failed rotator cuff repair may be difficult, especially in young patients. Various nonmodifiable and modifiable patient factors, including age, tendon quality, rotator cuff tear characteristics, acute or chronic rotator cuff tear, bone quality, tobacco use, and medications, affect rotator cuff repair healing. Surgical variables, such as the technique, timing, tension on the repair, the biomechanical construct, and fixation, as well as the postoperative rehabilitation strategy also affect rotator cuff repair healing...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28990575/a-systematic-review-of-the-concept-and-clinical-applications-of-bone-marrow-aspirate-concentrate-in-tendon-pathology
#20
Mohamed A Imam, James Holton, Saman Horriat, Ahmed S Negida, Florian Grubhofer, Rohit Gupta, Ali Narvani, Martyn Snow
Tendon pathologies are a group of musculoskeletal conditions frequently seen in clinical practice. They can be broadly classified into traumatic, degenerative and overuse-related tendinopathies. Rotator cuff tears, Achilles tendinopathy and tennis elbow are common examples of these conditions. Conventional treatments have shown inconsistent outcomes and might fail to provide satisfactory clinical improvement. With the growing trend towards the use of mesenchymal stem cells (MSCs) in other branches of medicine, there is an increasing interest in treating tendon pathologies using the bone marrow MSC...
2017: SICOT-J
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