Footprint preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A randomized controlled trial.

Autor: Ruiz Ibán MA; Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain. drmri@hotmail.com., Sanchez Alepuz E; Hospital IMED Valencia, Valencia, Spain., Diaz Heredia J; Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain., Hachem AI; Head of the Shoulder Unit, Hospital Universitario de Bellvitge, Barcelona, Spain., Ezagüi Bentolila L; Hospital Egarsat, Barcelona, Spain., Calvo A; Arthrosport, Zaragoza, Spain., Verdú C; Unidad de Hombro y Codo, Hospital General Universitario de Elche, Elche, Alicante, Spain., de Rus Aznar I; Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain., Soler Romagosa F; Traumadvance, Terrassa, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Jul; Vol. 29 (7), pp. 2249-2256. Date of Electronic Publication: 2020 Jun 01.
DOI: 10.1007/s00167-020-06073-7
Abstrakt: Purpose: To evaluate if adding nanofractures to the footprint of a supraspinatus tear repair would have any effect in the outcomes at one-year follow-up.
Methods: Multicentric, triple-blinded, randomized trial with 12-months follow-up. Subjects with isolated symptomatic reparable supraspinatus tears smaller than 3 cm and without grade 4 fatty infiltration were included. These were randomized to two groups: In the Control group an arthroscopic supraspinatus repair was performed; in the Nanofracture group the footprint was additionally prepared with nanofractures (1 mm wide, 9 mm deep microfractures). Clinical evaluation was done with Constant score, EQ-5D-3L, and Brief Pain Inventory. The primary outcome was the retear rate in MRI at 12-months follow-up. Secondary outcomes were: characteristics of the retear (at the footprint or at the musculotendinous junction) and clinical outcomes.
Results: Seventy-one subjects were randomized. Two were lost to follow-up, leaving 69 participants available for assessment at 12-months follow-up (33 in the Control group and 36 in the Nanofracture Group). The Nanofracture group had lower retear rates than the Control group (7/36 [19.4%] vs 14/33 [42.4%], differences significant, p = 0.038). Retear rates at the musculotendinous junction were similar but the Nanofracture group had better tendon healing rates to the bone (34/36 [94.4%] vs. 24/33 [66.71%], p = 0.014). Clinically both groups had significant improvements, but no differences were found between groups.
Conclusion: Adding nanofractures at the footprint during an isolated supraspinatus repair lowers in half the retear rate at 12-months follow-up. This is due to improved healing at the footprint.
Level of Evidence: Level I.
Databáze: MEDLINE
Externí odkaz: