Rotator cuff tears greater than or equal to 3 cm along with previously failed or revision rotator cuff tears are considered the most challenging in achieving primary anatomic healing, with reported failure rates as high as 94%. Shoulder, rotator cuff, rotator cuff repair, synthetic patch, graft. Seventeen consecutive patients with massive rotator cuff tears were treated with a standardized open repair technique and the repair augmented with graft jacket wright medical, memphis, tennessee. Rotator cuff tendon tears are common and can lead to. The rotation medical rotator cuff system induces formation of wellintegrated and new mature tendon like tissue in the injured tendon. Surgical treatment of massive rotator cuff tears is challenging for shoulder surgeons. The process of tendon healing to bone occurs slowly, only achieving approximately onethird the ultimate load to failure of a normal tendon attachment at 12 weeks in a goat model. Neviaser et al 31 first reported the use of an interposition allograft for rotator cuff repair in 1978, using freezedried rotator cuff tendon. T1 biomechanical effect of patch graft for large rotator cuff tears. Introduction rotator cuff tear is an important cause of shoulder pain and. Although rotator cuff repair reliably improves patient functional outcomes and satisfaction. The str graft, according to the announcement, is a threedimensional braided engineered matrix that, cato laurencin, m.
The purpose of this article is to familiarize the sports medicine community with several tendon augmentation grafts. Management of rotator cuff tears with an extracellular matrix patch. Evaluating the outcomes of rotator cuff repairs with. A severe but common rotator cuff problem is a rotator cuff tendon tear. These patches include both allograft and xenografts. Massive and irreparable rotator cuff tears are difficult to manage surgically.
Tendon patch grafting using the long head of the biceps. N2 it is not possible for some rotator cuff tears to be repaired because of a large defect associated with muscle. Biomechanical effect of patch graft for large rotator cuff. Patchaugmented rotator cuff surgery parcs studyprotocol for a. Jun 18, 2010 surgical treatment of massive rotator cuff tears is challenging for shoulder surgeons. Rotator cuff surgery technique tricks body with bovine implant. Arthroscopic replacement of massive, irreparable rotator cuff tears.
The aim of the patchaugmented rotator cuff surgery parcs feasibility. The purpose of this study was to investigate both clinical outcomes and cuff integrity after tendon patch grafting using the long head of the biceps lhb tendon for irreparable massive rotator cuff tears. A short deltoid splitting approach was used to expose the torn cuff tendon stump. Since then, a variety of materials have been developed and tested, including synthetic grafts, xenografts, and allografts. Tendon graft substitutes rotator cuff patches coons, david a.
Healing rates for challenging rotator cuff tears utilizing an. One technique to improve tendon healing has been the use of synthetic or biologic patch reinforcement. On january 3, 20, the company announced fda clearance to market its str graft, a biodegradable scaffold used for, soft tissue augmentation and rotator cuff repair. Outcomes after patch use in rotator cuff repair dr. Tendon healing and improved strength in the face of massive rotator cuff tear repair remains a daunting challenge.
Patients included those with a synthetic patch inserted as an interposition graft for large andor. New rotator cuff repair technique uses dissolving scaffold. Patch offers rapid rotator cuff repair orthopedics this week. Dermal collagen patch augmentation may increase the primary stability and strength of. We hypothesized that incorporation of a patch graft at the time of rotator cuff repair.
Mar 16, 2016 there is an ongoing debate about the potential of patch augmentation to improve biomechanical stability and healing associated with rotator cuff repair. Factors to consider when choosing a rotator cuff augment include origin, processing, physical properties, and clinical results. There is an ongoing debate about the potential of patch augmentation to improve biomechanical stability and healing associated with rotator cuff repair. Tendon patch grafting using the long head of the biceps for. To date, extracellular matrix ecmderived scaffolds have been the most commonly used grafts to augment rotator cuff repair 19. Arthroscopic treatment of irreparable rotator cuff tears using. Dermal collagen patch augmentation may increase the primary stability and strength. Healing rates for challenging rotator cuff tears utilizing. Use of graft jacket as an augmentation for massive rotator. Graft patches or tendon onlays based on decellularized allogeneic. Fullthickness rotator cuff tears are common in the aging population, with an estimated incidence between 28% and 40% in patients aged 60 years. Despite this, other synthetic grafts have not fared well in humans over the.
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