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Rotator cuff augmentation

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https://www.readbyqxmd.com/read/29198938/outcomes-of-arthroscopic-revision-rotator-cuff-repair-with-acellular-human-dermal-matrix-allograft-augmentation
#1
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
#2
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...
November 22, 2017: 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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28970995/rotator-cuff-tears-at-the-musculotendinous-junction-classification-and-surgical-options-for-repair-and-reconstruction
#8
Peter J Millett, Zaamin B Hussain, Erik M Fritz, Ryan J Warth, J Christoph Katthagen, Jonas Pogorzelski
Although uncommon, rotator cuff tears that occur medially at the musculotendinous junction can result from acute trauma, anatomic force imbalance, or medial row cuff failure following a previous rotator cuff repair. The quality of the torn muscle and tendon along with the length of the remnant tendon stump should be considered before deciding on the most appropriate repair technique. When muscle and tendon quality are sufficient, the tear can often be repaired directly to the remnant tendon stump and compressed onto the greater tuberosity...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28970994/arthroscopic-revision-of-medial-rotator-cuff-failure-augmented-with-a-bioabsorbable-patch
#9
Eduard Buess, Michael Hackl, Peter Buxbaumer
When revising failed double-row and suture-bridge rotator cuff repairs medial failures represent a potential feature. In the presence of a compromised healing environment, patch augmentation becomes a logical adjunct from a mechanical and biological point of view. A reproducible step-by-step revision technique is described that reinforces the weak central cuff area with an absorbable synthetic scaffold.
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28949253/application-of-a-demineralized-cortical-bone-matrix-and-bone-marrow-derived-mesenchymal-stem-cells-in-a-model-of-chronic-rotator-cuff-degeneration
#10
Tanujan Thangarajah, Anita Sanghani-Kerai, Frederick Henshaw, Simon M Lambert, Catherine J Pendegrass, Gordon W Blunn
BACKGROUND: The success of rotator cuff repair is primarily dependent on tendon-bone healing. Failure is common because weak scar tissue replaces the native enthesis, rendering it prone to reruptures. A demineralized bone matrix (DBM) consists of a network of collagen fibers that provide a sustained release of growth factors such as bone morphogenetic proteins. Previous studies have demonstrated that it can regenerate a fibrocartilaginous enthesis. HYPOTHESIS: The use of a DBM and mesenchymal stem cells (MSCs) at the healing enthesis will result in a higher bone mineral density at the tendon insertion and will enhance the regeneration of a morphologically superior enthesis when compared with an acellular human dermal matrix...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28932752/local-rhbmp-12-on-an-absorbable-collagen-sponge-as-an-adjuvant-therapy-for-rotator-cuff-repair-a-phase-1-randomized-standard-of-care-control-multicenter-study-part-2-a-pilot-study-of-functional-recovery-and-structural-outcomes
#11
Junji Ide, Yu Mochizuki, Arthur van Noort, Hiroshi Ochi, Sudhakar Sridharan, Eiji Itoi, Stefan Greiner
BACKGROUND: The high failure rate of rotator cuff repairs requires the development of methods to enhance healing at the tendon-bone junction of the repair site. PURPOSE: To assess functional recovery and structural outcomes in detail after implanting recombinant human bone morphogenetic protein-12 (rhBMP-12)/absorbable collagen sponge (ACS) as adjuvant treatment during open rotator cuff repair in patients over a 1-year postoperative follow-up. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28905242/poly-n-acetyl-glucosamine-snag-enhances-early-rotator-cuff-tendon-healing-in-a-rat-model
#12
C A Nuss, J Huegel, J F Boorman-Padgett, D S Choi, S N Weiss, J Vournakis, L J Soslowsky
Rotator cuff injuries frequently require surgical repairs which have a high failure rate. Biological augmentation has been utilized in an attempt to improve tendon repair. Poly-N-acetyl glucosamine (sNAG) polymer containing nanofibers has been shown to increase the rate for healing of venous leg ulcers. The purpose of this study was to investigate the healing and analgesic properties of sNAG in a rat rotator cuff injury and repair model. 144 adult male Sprague-Dawley rats underwent a transection and repair of their left supraspinatus tendons...
December 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28822637/porcine-dermis-patch-augmentation-of-supraspinatus-tendon-repairs-a-pilot-study-assessing-tendon-integrity-and-shoulder-function-2%C3%A2-years-after-arthroscopic-repair-in-patients-aged-60%C3%A2-years-or%C3%A2-older
#13
Matthias Flury, Dominik Rickenbacher, Christian Jung, Marco M Schneider, David Endell, Laurent Audigé
PURPOSE: To investigate the 2-year postoperative clinical and subjective outcomes after arthroscopic rotator cuff repair (ARCR) with xenologous porcine dermal patch augmentation compared with ARCR alone. METHODS: Patients aged 60 years or older with a complete supraspinatus (SSP) tendon tear underwent primary ARCR with a transosseous-equivalent technique. By use of a matched-pair comparative trial design, a consecutive series of 20 patients receiving additional xenologous porcine dermal patch augmentation (patch group) was matched by tear location with 20 patients who received ARCR only (control group)...
August 16, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28820278/does-additional-biceps-augmentation-improve-rotator-cuff-healing-and-clinical-outcomes-in-anterior-l-shaped-rotator-cuff-tears-clinical-comparisons-with-arthroscopic-partial-repair
#14
Yoon Sang Jeon, Juyeob Lee, Rag Gyu Kim, Young-Won Ko, Sang-Jin Shin
BACKGROUND: The repair of anterior L-shaped tears is usually difficult because of the lack of anterior rotator cuff tendon to cover the footprint. The biceps tendon is usually exposed from the retracted anterolateral corner of the torn tendon and can be easily used to augment rotator cuff repair. Hypothesis/Purpose: This study compared the clinical outcomes of the biceps augmentation technique with those of partial tendon repair for the arthroscopic treatment of large anterior L-shaped rotator cuff tears to evaluate the role of additional biceps augmentation in tendon healing...
November 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28816097/-meltblown-polymer-fabrics-as-candidate-scaffolds-for-rotator-cuff-tendon-tissue-engineering
#15
Thomas L Jenkins, Sean Meehan, Behnam Pourdeyhimi, Dianne Little
Various biomaterial technologies are promising for tissue engineering, including electrospinning, but commercial scale-up of throughput is difficult. The goal of the study was to evaluate meltblown fabrics as candidate scaffolds for rotator cuff tendon tissue engineering. Meltblown poly(lactic acid) fabrics were produced with several polymer crystallinities and airflow velocities [500(low), 900(medium) or 1400(high) m(3)air/h/m fabric]. Fiber diameter, alignment, and baseline bidirectional tensile mechanical properties were evaluated...
September 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28736687/tissue-engineered-tendon-for-enthesis-regeneration-in-a-rat-rotator-cuff-model
#16
Michael J Smietana, Pablo Moncada-Larrotiz, Ellen M Arruda, Asheesh Bedi, Lisa M Larkin
Healing of rotator cuff (RC) injuries with current suture or augmented scaffold techniques fails to regenerate the enthesis and instead forms a weaker fibrovascular scar that is prone to subsequent failure. Regeneration of the enthesis is the key to improving clinical outcomes for RC injuries. We hypothesized that the utilization of our tissue-engineered tendon to repair either an acute or a chronic full-thickness supraspinatus tear would regenerate a functional enthesis and return the biomechanics of the tendon back to that found in native tissue...
2017: BioResearch Open Access
https://www.readbyqxmd.com/read/28706817/the-pull-over-technique-for-all-arthroscopic-rotator-cuff-repair-with-extracellular-matrix%C3%A2-augmentation
#17
A Ali Narvani, Mohamed A Imam, Ioannis Polyzois, Tanaya Sarkhel, Rohit Gupta, Ofer Levy, Paolo Consigliere
Despite the vast improvement in techniques for arthroscopic rotator cuff surgery, repairs of massive and large tears remain an issue as they are associated with significantly high failure rates, particularly in the elderly population. As a result, there has been a focus of attention to improve rotator cuff repair healing rates. One of the strategies is augmentation of the repair with a patch. Arthroscopic augmentation is, however, technically demanding with challenges in introduction and stabilization of the patch...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28699149/is-the-clavicula-pro-humero-technique-of-value-for-reconstruction-after-resection-of-the-proximal-humerus-in-children
#18
Dominique Barbier, Benoît De Billy, Philippe Gicquel, Sophie Bourelle, Pierre Journeau
BACKGROUND: There are several options for reconstruction of proximal humerus resections after wide resection for malignant tumors in children. The clavicula pro humero technique is a biologic option that has been used in the past, but there are only scant case reports and small series that comment on the results of the procedure. Because the longevity of children mandates a reconstruction with potential longevity not likely to be achieved by other techniques, the clavicula pro humero technique may be a potential option in selected patients...
October 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28670360/pain-and-the-pathogenesis-of-biceps-tendinopathy
#19
REVIEW
Elise B Raney, Finosh G Thankam, Matthew F Dilisio, Devendra K Agrawal
Biceps tendinopathy is a relatively common ailment that typically presents as pain, tenderness, and weakness in the tendon of the long head of the biceps brachii. Though it is often associated with degenerative processes of the rotator cuff and the joint, this is not always the case, thus, the etiology remains considerably unknown. There has been recent interest in elucidating the pathogenesis of tendinopathy, since it can be an agent of chronic pain, and is difficult to manage. The purpose of this article is to critically evaluate relevant published research that reflects the current understanding of pain and how it relates to biceps tendinopathy...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28647842/excellent-healing-rates-and-patient-satisfaction-after-arthroscopic-repair-of-medium-to-large-rotator-cuff-tears-with-a-single-row-technique-augmented-with-bone-marrow-vents
#20
Brian D Dierckman, Jake J Ni, Ronald P Karzel, Mark H Getelman
PURPOSE: This study evaluated the repair integrity and patient clinical outcomes following arthroscopic rotator cuff repair of medium to large rotator cuff tears using a single-row technique consisting of medially based, triple-loaded anchors augmented with bone marrow vents in the rotator cuff footprint lateral to the repair. METHODS: This is a retrospective study of 52 patients (53 shoulders) comprising 36 males and 16 females with a median age of 62 (range 44-82) with more than 24-month follow-up, tears between 2 and 4 cm in the anterior-posterior dimension and utilizing triple-loaded anchors...
June 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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