Bio-inductive implant for rotator cuff repair: our experience and technical notes.

Gian Mario Micheloni; Gianpaolo Salmaso; Gino Zecchinato; Stefano Giaretta; Elia Barison; Alberto Momoli

doi:10.23750/abm.v91i14-S.10824

Bio-inductive implant for rotator cuff repair: our experience and technical notes.

Authors

Gian Mario Micheloni a:1:{s:5:"en_US";s:46:"San Bortolo Hospital - Vicenza - AULSS8 Berica";}
Gianpaolo Salmaso San Bortolo Hospital - Vicenza - AULSS8 Berica
Gino Zecchinato San Bortolo Hospital - Vicenza - AULSS8 Berica
Stefano Giaretta San Bortolo Hospital - Vicenza - AULSS8 Berica
Elia Barison San Bortolo Hospital - Vicenza - AULSS8 Berica
Alberto Momoli San Bortolo Hospital - Vicenza - AULSS8 Berica

DOI: https://doi.org/10.23750/abm.v91i14-S.10824

Keywords:

bio-inductive implant, patch, rotator cuff tear, rotator cuff repair

Abstract

The treatment of chonic large and partial rotator cuff tears represents a common challenge for orthopedic surgeons. Numerous treatments were suggested but the best is still controversial. Into this field the use of an augment for rotator cuff repair aims to protect the tension of the suture in the postoperative phase and to facilitate the biological healing process. In our institution we treated 4 patients (3 males and 1 female) with rotator cuff tear with bio-inductive implant. All patients presented with a postero-superior rotator cuff tear: 3 patients with a type C-III tear according to Snyder classification and 1 patient with partial articular tear with significant degeneration and poor tendon quality (type A-III tear according to Snyder classification). The final outcome is highly satisfying intraoperatively and the postoperative protocol reflects our normal postoperative protocol following to rotator cuff repair. No complications occurred at 6 months follow-up. The use of the bio-inductive implant in the arthroscopic rotator cuff repair resulted easy, rapid and reproducible. Although no current scientific evidences regarding such implants exist, in selected cases and with the correct indications, the use of bio-inductive implant could represent an effective aid and an option in case of complex rotator cuff tears

References

Audenaert E, Nuffel VJ, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatology Arthrosc. 2006;14(4):360–4.

Avanzi P, Dei Giudici L, Capone A, Cardoni G, Lunardi G, Foti G et al. Prospective randomized controlled trial for patch augmentation in rotator cuff repair: 24-month outcomes. J Shoulder Elbow Surg.2019;28(10):1918-1927.

Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86-A(2):219–24.

Bernazzani M, McMartin T, Garbis N. Repairing PASTA Lesions Without Violation of the Rotator Cuff. Arthrosc Tech. 2020 Jun 9;9(7):e883-e887.

Snyder S. Arthroscopic Classification of Rotator Cuff Lesions and Surgical Decision Making. Philadelphia: Lippincott Williams & Wilkins; 2002.

Millstein ES, Snyder SJ. Arthroscopic evaluation and management of rotator cuff tears. Orthop Clin North Am. 2003;34(4):507-520.

Davidson J, Burkhart S. The geometric classification of rotator cuff tears: a system linking tear pattern to treatment and prognosis. Arthroscopy. 2010:26(3):417-424.

Sun L, Zhang Q, Ge HA, Sun Y, Cheng B. Which is the best repair of articular-sided rotator cuff tears: A metaanalysis. J Orthop Surg Res. 2015;10:84.

Deutsch A. Arthroscopic repair of partial-thickness tears of the rotator cuff. J Shoulder Elbow Surg. 2007;16:193-201.

Castricini R, La Camera F, De Gori M, Orlando N, De Benedetto M, Galasso O et al. Functional outcomes and repair integrity after arthroscopic repair of partial articular supraspinatus tendon avulsion. Arch Orthop Trauma Surg. 2018;139:369-375.

Park JY, Lhee SH, Oh KS, Moon SG, Hwang JT. Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear. Arthroscopy. 2013:29(2):280-289.

Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL. Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg. 2006;15:290e9.

Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89:953e60.

Ricci M, Vecchini E, Bonfante E, Micheloni GM, Berti M, Schenal G et al. A clinical and radiological study of biodegradable subacromial spacer in the treatment of massive irreparable rotator cuff tears. Acta Biomed. 2017;88(4S):75-80.

Stewart RK, Kaplin L, Parada SA, Graves BR, Verma NN, Waterman BR. Outcomes of subacromial balloon spacer implantation for massive and irreparable rotator cuff tears: a systematic review. Orthop J Sports Med. 2019:7(10), 2325967119875717.

Derwin KA, Badylak SF, Steinmann SP, Iannotti JP. Extracellular matrix scaffold devices for rotator cuff repair. J Shoulder Elb Surg. 2010;19(3):467–76.

Chalmers PN, Frank RM, Gupta AK, Yanke AB, Trenhaile SW, Romeo AA et al.All-arthroscopic patch augmentation of amassive rotator cuff tear: surgical technique. Arthrosc Techniques. 2013;2(4):e447–51.

Flury M, Rickenbacher D, Jung C, Schneider MM, Endell D, Audigé L. Porcine dermis patch augmentation of supraspinatus tendon repairs: a pilot study assessing tendon integrity and shoulder function 2 years after arthroscopic repair in patients aged 60 years or older. Arthroscopy. 2018;34(1):24–37.

Karuppaiah K, Sinha J. Scaffolds in the management of massive rotator cuff tears: current concepts and literature review. EFORT open reviews. 2019;4(9): 557-566.

Chalmers PN, Tashjian RZ. Patch Augmentation in Rotator Cuff Repair. Curr Rev Musculoskelet Med. 2020;13(5)561-571.

McIntyre LF, Bishai SK, Brown III PB, Bushnell BD, Trenhaile SW. Patient-reported outcomes after use of a bioabsorbable collagen implant to treat partial and full-thickness rotator cuff tears. Arthroscopy. 2019;35(8):2262-2271.