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). Clinical results on PRP application have been controversial. Application of MSCs has shown promise in animal studies, but clinical data on its effectiveness is presently lacking. The role of Matrix Metalloproteinase (MMP) inhibitors is another interesting field for potential targeted drug therapy after rotator cuff repair.
Conclusions: Large randomized clinical studies need to confirm the benefit of these approaches, in order to eventually lower retear rates and improve clinical outcomes after rotator cuff repair.
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http://dx.doi.org/10.2174/1874325001610010309 | DOI Listing |
J Orthop Res
December 2024
Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
This study investigates the therapeutic potential of Msx1-overexpressing bone marrow mesenchymal stem cells (BMSCs) in enhancing tendon-bone healing in rotator cuff injuries. BMSCs were genetically modified to overexpress Msx1 and were evaluated in vitro for their proliferation, migration, and differentiation potential. Results demonstrated that Msx1 overexpression significantly increased BMSC proliferation and migration while inhibiting osteogenic and chondrogenic differentiation.
View Article and Find Full Text PDFWest Afr J Med
August 2024
Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. Email: Tel: 08063241116.
Background/objective: Rheumatic diseases (RMDs) are among the leading health burdens and causes of disability globally. Interestingly, they are on the rise due to the increasingly ageing population. Inflammatory RMDs are not left behind in the rise, especially in Africa, where they were thought to be rare as there has been increasing reportage of these diseases in recent years.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address:
Purpose: To determine if the fatty infiltration of rotator cuff muscles, as measured by magnetic resonance imaging (MRI) preoperatively and assessed using the Goutallier Fatty Degeneration Index (GFDI), can predict early post-operative shoulder stiffness (POSS) following rotator cuff repair (RCR).
Methods: This retrospective longitudinal cohort study included patients who underwent primary RCR, had available medical records, and underwent MRI before RCR between November 2012 and July 2022. Patients were excluded based on the following criteria: (1) preoperative shoulder stiffness, (2) additional procedures (e.
Sports Med Arthrosc Rev
October 2024
Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Istituto Clinico Ortopedico Traumatologico (ICOT), Latina, Italy.
Unlabelled: Several medical conditions (diabetes, cardio-vascular diseases, hypercholesterolemia etc.) or modifiable behavioral habits (smoking habit and alcohol assumption) capable of causing a damage to the peripheral microcirculation are considered potential risk factors for degeneration/tear of the rotator cuff. The aim of the study was to analyse and quantify how the association of multiple known risk factors is more effective than the predisposing action of a single factor.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea.
Background: Muscle atrophy after the rupture of a rotator cuff (RC) tendon is a major factor that increases the risk of secondary complications and re-rupture. Metformin, a type 2 diabetes treatment, can be used to modulate intracellular signaling pathways that promote muscle growth. This study aimed to verify whether systemic metformin administration could prevent supraspinatus (SS) atrophy after RC rupture in a rat model.
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