Bursal Acromial Reconstruction (BAR) Using an Acellular Dermal Allograft as a Surgical Solution for the Treatment of Massive Irreparable Rotator Cuff Tears.

Autor:	Ravenscroft M; Orthteam Centre, Manchester, England., Barnes MW; Orthteam Centre, Manchester, England., Muench LN; Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany., Mazzocca AD; Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A., Berthold DP; Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
Jazyk:	angličtina
Zdroj:	Arthroscopy techniques [Arthrosc Tech] 2021 Feb 22; Vol. 10 (3), pp. e877-e885. Date of Electronic Publication: 2021 Feb 22 (Print Publication: 2021).
DOI:	10.1016/j.eats.2020.11.002
Abstrakt:	Massive, irreparable rotator cuff tears in patients without severe signs of osteoarthritis remains a major challenge for orthopaedic surgeons. These can be a source of significant pain and functional loss occurring most commonly in a relatively frail, elderly patient population. A plethora of surgical techniques covering minimally invasive, arthroscopic techniques and open, salvage procedures have been described for this challenging patient cohort. Continuous evolvement of arthroscopic techniques has led to all-arthroscopic superior capsular reconstruction techniques using allografts, thereby reducing donor side morbidity along with decreased soft tissue dissection. However, conventional superior capsular reconstruction is noted to be a technically complex, time-consuming, and high-cost surgery, which may put this technique beyond the confidence of many shoulder surgeons. The subacromial balloon spacer has emerged as a potential solution in these patients, providing interposition between the humeral head and acromion. However, the subacromial balloon biodegrades rapidly and its effect is only temporary. Thus this technique article presents using an acellular human dermal allograft to reconstruct the bursal layer, which is normally interposed between the humeral head and the acromion. The proposed technique provides a permanent interposition graft preventing humeral acromial contact, which does not undergo rapid biodegradation. The surgical technique is technically feasible, both minimizing surgical time and therefore operative risk to the patient. (© 2020 by the Arthroscopy Association of North America. Published by Elsevier.)
Databáze:	MEDLINE
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