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. Outcome data included American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores, as well as rotator cuff healing on magnetic resonance imaging or ultrasound. Retears and subsequent surgical procedures were characterized.
Results: A total of 28 patients met our inclusion criteria, and 23 (82%) were available for follow-up at 2 years. The mean age was 60.1 ± 9.3 years (range, 43-79 years), with a mean follow-up period of 48 ± 23 months. All patients had at least 1 prior rotator cuff repair. Of the 23 patients, 13 (56%) underwent postoperative imaging, and 4 of these 13 (31%) had a retear. A reoperation was performed in 3 of 23 patients (13%). Among the 6 patients with both preoperative and postoperative outcome scores, we saw improvement in the ASES score from 56 to 85 (P = .03) and in the SANE score from 42 to 76 (P = .03). The full cohort's mean postoperative ASES and SANE scores were 77 and 69, respectively.
Conclusion: AHDM allograft augmentation is a safe and effective treatment method for patients with full-thickness rotator cuff retears. Further research is needed with larger studies to confirm these findings from our small cohort of patients.
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http://dx.doi.org/10.1016/j.jse.2017.09.026 | DOI Listing |
BMC Musculoskelet Disord
January 2025
Department of Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA.
Background: Rotator cuff repairs may fail because of compromised blood supply, suture anchor pullout, or poor fixation to bone. To augment the repairs and promote healing of the tears, orthobiologics, such a platelet-rich plasma (PRP), and biologic scaffolds have been applied with mixed results. Adipose allograft matrix (AAM), which recruits native cells to damaged tissues, may also be a potential treatment for rotator cuff tears.
View Article and Find Full Text PDFOrthop Surg
January 2025
Department of Orthopaedics and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Objectives: Edema after shoulder arthroscopic surgery poses concerns due to its potential complications such as compartment syndrome, nerve damage, and respiratory issues. This study aimed to investigate the acute accumulation of subcutaneous fluid after shoulder arthroscopy.
Methods: A prospective cohort study, providing Level III evidence was conducted on 50 patients undergoing arthroscopic shoulder surgery under interscalene block anaesthesia from September to December 2023.
Biomater Adv
January 2025
Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd., Shanghai 200233, PR China. Electronic address:
Improving the regeneration of the tendon-bone interface (TBI) helps to decrease the risk of rotator cuff retears after repair surgeries. Unfortunately, the lack of inherent healing capacity of the TBI, insufficient mechanical properties, and abnormal and persistent inflammation during repair are the key factors leading to suboptimal healing of the rotator cuff. Therefore, a high-strength rotator cuff repair material capable of regulating the unbalanced immune response and enhancing the regeneration of the TBI is urgently needed.
View Article and Find Full Text PDFJ Bone Joint Surg Am
November 2024
Department of Orthopaedic Surgery, Harvard Medical School, Boston Shoulder Institute, Massachusetts General Hospital, Boston, Massachusetts.
Background: Rotator cuff repair (RCR) is a frequently performed outpatient orthopaedic surgery, with substantial financial implications for health-care systems. Time-driven activity-based costing (TDABC) is a method for nuanced cost analysis and is a valuable tool for strategic health-care decision-making. The aim of this study was to apply the TDABC methodology to RCR procedures to identify specific avenues to optimize cost-efficiency within the health-care system in 2 critical areas: (1) the reduction of variability in the episode duration, and (2) the standardization of suture anchor acquisition costs.
View Article and Find Full Text PDFShoulder Elbow
January 2025
IU Health Physicians Orthopedics & Sports Medicine, Indianapolis, IN, USA.
Purpose: The purpose of this study is to assess the long-term clinical complications, outcomes, and return to sport (RTS) rates in patients aged 30 or younger with a primary full-thickness arthroscopic rotator cuff repair (ARCR).
Methods: All patients who underwent a primary full-thickness ARCR at age 30 years or younger from 2003 to 2021 with a minimum of a 2-year follow-up were included. Complications, repeat surgeries, and return to sport rates were collected.
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