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Rotator cuff augmentation

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https://www.readbyqxmd.com/read/27909664/arthroscopic-assisted-lower-trapezius-tendon-transfer-for-massive-irreparable-posterior-superior-rotator-cuff-tears-surgical-technique
#1
Bassem T Elhassan, Eduard Alentorn-Geli, Andrew T Assenmacher, Eric R Wagner
Tendon transfer options to reconstruct a massive irreparable posterior-superior rotator cuff tear include latissimus dorsi, teres major, or lower trapezius transfer. We previously described the lower trapezius transfer using a 2-incision approach, which includes a medial incision to harvest the lower trapezius and lateral transacromial incision to expose the rotator cuff and then perform the transfer through a deep tunnel connecting these 2 sites. In this report, we describe an arthroscopic-assisted technique of lower trapezius transfer augmented with an Achilles tendon allograft to reconstruct an irreparable posterior-superior rotator cuff tear...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27887870/involvement-of-indian-hedgehog-signaling-in-mesenchymal-stem-cell-augmented-rotator-cuff-tendon-repair-in-an-athymic-rat-model
#2
Jian-Chun Zong, Michael J Mosca, Ryan M Degen, Amir Lebaschi, Camila Carballo, Andrew Carbone, Guang-Ting Cong, Liang Ying, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Bone marrow aspirate has been used in recent years to augment tendon-to-bone healing, including in rotator cuff repair. However, the healing mechanism in cell-based therapy has not been elucidated in detail. METHODS: Sixteen athymic nude rats were randomly allocated to 2 groups: experimental (human mesenchymal stem cells in fibrin glue carrier) and control (fibrin glue only). Animals were sacrificed at 2 and 4 weeks. Immunohistochemical staining was performed to evaluate Indian hedgehog (Ihh) signaling and SOX9 signaling in the healing enthesis...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27855678/augmentation-and-repair-of-tendons-using-demineralised-cortical-bone
#3
Sherif Elnikety, Catherine J Pendegrass, Roberta Ferro de Godoy, Charles Holden, Gordon W Blunn
BACKGROUND: In severe injuries with loss of tendon substance a tendon graft or a synthetic substitute is usually used to restore functional length. This is usually associated with donor site morbidity, host tissue reactions and lack of remodelling of the synthetic substitutes, which may result in suboptimal outcome. A biocompatible graft with mechanical and structural properties that replicate those of normal tendon and ligament has so far not been identified. The use of demineralised bone for tendon reattachment onto bone has been shown to be effective in promoting the regeneration of a normal enthesis...
November 17, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27814629/advances-in-the-treatment-of-rotator-cuff-lesions-by-cytokines
#4
Genbin Wu, Peng Cheng Xu, Peng Wu, Kaihua Hu, Yeqing Sun, Biao Cheng, Yong Lu
Rotator cuff tears are one of the most common shoulder problems that usually require operative treatments. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. Although surgical treatments have improved dramatically up to now, shoulder pathology is still challenging to orthopedic surgery primarily because these injuries often respond poorly to treatment and require prolonged rehabilitation. Recent attention has focused on several biologic pathways which can augment function to tendon healing, consequently leading to the identification of growth factors involved in this process...
January 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/27768610/biologic-and-synthetic-grafts-in-the-reconstruction-of-large-to-massive-rotator-cuff-tears
#5
Robert J Gillespie, Derrick M Knapik, Ozan Akkus
Rotator cuff injuries are common in both young and elderly patients. Despite improvements in instrumentation and surgical techniques, the failure rates following tendon reconstruction remain unacceptably high. To improve outcomes, graft patches have been developed to provide mechanical strength and to furnish a scaffold for biologic growth across the delicate tendon-bone junction. Although no patch effectively re-creates the structured, highly organized system of prenatal tendon development, augmenting rotator cuff repair may help restore native tendon-to-bone attachment while reproducing the mechanical and biologic properties of native tendon...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27750374/advances-in-biologic-augmentation-for-rotator-cuff-repair
#6
Sahishnu Patel, Anthony P Gualtieri, Helen H Lu, William N Levine
Rotator cuff tear is a very common shoulder injury that often necessitates surgical intervention for repair. Despite advances in surgical techniques for rotator cuff repair, there is a high incidence of failure after surgery because of poor healing capacity attributed to many factors. The complexity of tendon-to-bone integration inherently presents a challenge for repair because of a large biomechanical mismatch between the tendon and bone and insufficient regeneration of native tissue, leading to the formation of fibrovascular scar tissue...
November 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27720412/suture-spanning-augmentation-of-single-row-rotator-cuff-repair-a-biomechanical-analysis
#7
Nicholas A Early, John J Elias, Steven B Lippitt, Danielle E Filipkowski, Robert A Pedowitz, William J Ciccone
BACKGROUND: This in vitro study evaluated the biomechanical benefit of adding spanning sutures to single-row rotator cuff repair. METHODS: Mechanical testing was performed to evaluate 9 pairs of cadaveric shoulders with complete rotator cuff repairs, with a single-row technique used on one side and the suture spanning technique on the other. The spanning technique included sutures from 2 lateral anchors securing tendon near the musculotendinous junction, spanning the same anchor placement from single-row repair...
October 5, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27709043/endoscopic-gluteus-medius-repair-augmented-with-bioinductive-implant
#8
Daniel J Kaplan, Andrew P Dold, David J Fralinger, Robert J Meislin
Patients with gluteus minimus and medius tears that fail nonoperative management may be indicated for surgical repair; however, structural failure after gluteal tendon repair remains unacceptably high. This is likely related to the limited healing potential of tendinous tissue, which is poorly vascular and heals by formation of fibrocartilaginous scar tissue rather than histologically normal tendon. An emerging option to augment tendon healing is the use of a bioinductive implant that is designed to amplify the host healing response and induce the formation of healthy tendon tissue...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27709027/-owl-technique-for-all-arthroscopic-augmentation-of-a-massive-or-large-rotator-cuff-tear-with-extracellular-matrix-graft
#9
A Ali Narvani, Paolo Consigliere, Ioannis Polyzois, Tanaya Sarkhel, Rohit Gupta, Ofer Levy
Despite the vast improvement in techniques and technology for arthroscopic rotator cuff surgery, repairs of massive and large tears remain challenging because they are associated with significantly high failure rates. In recent years, patch augmentation has gained popularity as a technique to decrease these high failure rates. Arthroscopic patch augmentation of rotator cuff repair, however, is technically difficult. The purpose of this report is to describe a simple and reproducible technique for all-arthroscopic extracellular matrix graft augmentation...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27708733/patch-augmented-rotator-cuff-repair-and-superior-capsule-reconstruction
#10
M Petri, J A Greenspoon, S G Moulton, P J Millett
BACKGROUND: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27708732/the-role-of-platelet-rich-plasma-prp-and-other-biologics-for-rotator-cuff-repair
#11
Joshua A Greenspoon, Samuel G Moulton, Peter J Millett, Maximilian Petri
BACKGROUND: Surgical treatment of rotator cuff tears has consistently demonstrated good clinical and functional outcomes. However, in some cases, the rotator cuff fails to heal. While improvements in rotator cuff constructs and biomechanics have been made, the role of biologics to aid healing is currently being investigated. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: Biologic augmentation of rotator cuff repairs can for example be performed wtableith platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs)...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27665095/platelet-rich-plasma-in-tendon-related-disorders-results-and-indications
#12
Giuseppe Filardo, Berardo Di Matteo, Elizaveta Kon, Giulia Merli, Maurilio Marcacci
PURPOSE: Platelet-rich plasma (PRP) is currently the most exploited strategy in the clinical practice to provide a regenerative stimulus for tendon healing. The aim of the present study was to systematically review the available evidence on the treatment of the main tendon disorders where PRP is currently applied. METHODS: A systematic review of the literature was performed on the use of PRP as a treatment for tendinopathies focusing on the following sites: Achilles tendon, patellar tendon, rotator cuff tendons, and lateral elbow tendons...
September 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27660800/impact-of-platelet-rich-plasma-on-arthroscopic-repair-of-small-to-medium-sized-rotator-cuff-tears-a-randomized-controlled-trial
#13
Richard Holtby, Monique Christakis, Eran Maman, Joy C MacDermid, Tim Dwyer, George S Athwal, Kenneth Faber, John Theodoropoulos, Linda J Woodhouse, Helen Razmjou
BACKGROUND: Increased interest in using platelet-rich plasma (PRP) as an augment to rotator cuff repair warrants further investigation, particularly in smaller rotator cuff tears. PURPOSE: To examine the effectiveness of PRP application in improving perioperative pain and function and promoting healing at 6 months after arthroscopic repair of small- or medium-sized rotator cuff tears. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27650821/histologic-evaluation-of-biopsy-specimens-obtained-after-rotator-cuff-repair-augmented-with-a-highly-porous-collagen-implant
#14
Steven P Arnoczky, Shariff K Bishai, Brian Schofield, Scott Sigman, Brad D Bushnell, Jan Pieter Hommen, Craig Van Kampen
PURPOSE: To histologically evaluate biopsy specimens from patients who previously underwent rotator cuff repair augmented with a highly porous collagen implant. METHODS: Biopsies of collagen implant/host-tissue constructs were obtained from 7 patients undergoing a second arthroscopic procedure at various time periods (5 weeks to 6 months) after arthroscopic rotator cuff repair augmented with a collagen implant overlay. The biopsy specimens were examined histologically for host-tissue ingrowth, host-tissue maturation, and host-implant biocompatibility...
September 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27594327/editorial-commentary-reflections-from-a-mature-arthroscopic-shoulder-surgeon-on-the-history-and-current-benefits-of-augmentation-for-the-revision-of-a-massive-rotator-cuff-tear-using-acellular-human-dermal-matrix-allograft
#15
EDITORIAL
Stephen J Snyder
Acellular human dermal matrix allografts are now being used to augment and sometimes replace severely damaged rotator cuff tissue. I have been interested in this important aspect of orthopaedics for 15 years and am pleased to have the opportunity to share my personal reflections of some of the highlights in science and the literature that helped get to the point now where we can expect greater than 80% healing even in these difficult cases of revision after massive failed cuff repair. The field of tissue engineering will certainly be a critical part of our rotator cuff surgical future...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27594323/shoulder-problems-motivate-innovative-solutions
#16
EDITORIAL
James H Lubowitz, Jefferson C Brand, Michael J Rossi, Matthew T Provencher
Shoulder arthroscopic and related surgeons may require expertise in use of the 70° arthroscope, biologic patch augmentation, repair of massive rotator cuff tears, the Latarjet procedure and related glenoid bone augmentation, and reverse total shoulder arthroplasty.
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27552454/acellular-dermal-matrix-in-rotator-cuff-surgery
#17
Joseph Cooper, Raffy Mirzayan
The success of rotator cuff repair (RCR) surgery can be measured clinically (validated outcome scores, range of motion) as well as structurally (re-tear rates using imaging studies). Regardless of repair type or technique, most studies have shown that patients do well clinically. However, multiple studies have also shown that structurally, the failure rate can be very high. A variety of factors, including poor tendon quality, age over 63 years, smoking, advanced fatty infiltration into the muscle, and the inability of the tendon to heal to bone, have been implicated as the cause of the high re-tear rate in RCRs...
July 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27552452/platelet-rich-plasma-prp-in-orthopedic-sports-medicine
#18
Ryan A Mlynarek, Andrew W Kuhn, Asheesh Bedi
The use of platelet-rich plasma (PRP) injections in the treatment of musculoskeletal conditions has become more prevalent in recent years. Current literature has exhibited that PRP injections are relatively safe and can potentially accelerate or augment the soft tissue healing process. This review presents the most current literature update on the use of PRP in the treatment of rotator cuff tears, osteoarthritis of the knee, ulnar collateral ligament tears, lateral epicondylitis, hamstring injuries, and Achilles tendinopathy...
July 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27545050/a-randomized-clinical-trial-to-compare-the-effectiveness-of-rotator-cuff-repair-with-or-without-augmentation-using-porcine-small-intestine-submucosa-for-patients-with-moderate-to-large-rotator-cuff-tears-a-pilot-study
#19
Dianne Bryant, Richard Holtby, Kevin Willits, Robert Litchfield, Darren Drosdowech, Alison Spouge, David White, Gordon Guyatt
BACKGROUND: The rate of rotator cuff repair failure is between 13% and 67%. Porcine small intestine submucosa (SIS) may be suitable to augment the repair. METHODS: There were 62 patients with moderate and large cuff tears randomized to repair alone (control) or augmentation with SIS (Restore Orthobiologic Implant; DePuy, Warsaw, IN, USA). Primary outcome was repair failure using magnetic resonance arthrography. Randomization occurred on completion of the repair...
October 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27500782/autologous-tendon-derived-cell-seeded-nanofibrous-scaffolds-improve-rotator-cuff-repair-in-an-age-dependent-fashion
#20
Julianne Huegel, Dong Hwa Kim, James M Cirone, Adam M Pardes, Tyler R Morris, Courtney A Nuss, Robert L Mauck, Louis J Soslowsky, Andrew F Kuntz
Rotator cuff tendon tears are one of the most common shoulder pathologies, especially in the aging population. Due to a poor healing response and degenerative changes associated with aging, rotator cuff repair failure remains common. Although cell-based therapies to augment rotator cuff repair appear promising, it is unknown whether the success of such a therapy is age-dependent. We hypothesized that autologous cell therapy would improve tendon-to-bone healing across age groups, with autologous juvenile cells realizing the greatest benefit...
August 8, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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