Arthroscopic Repair of Retracted Large and Massive Rotator Cuff Tears With and Without Augmentation With a Bio-Inductive Collagen Implant Reveals Substantial and Comparable Clinical Improvement.

Autor:	Zhang T; Mercy Health-Cincinnati SportsMedicine and Orthopaedic Center, Cincinnati SportsMedicine Research and Education Foundation, Cincinnati, Ohio, U.S.A., Ajayi A; Shady Grove Orthopaedics, Rockville, Maryland, U.S.A., Hajjar M; Mercy Health-Cincinnati SportsMedicine and Orthopaedic Center, Cincinnati SportsMedicine Research and Education Foundation, Cincinnati, Ohio, U.S.A., Fleckenstein CM; Mercy Health-Cincinnati SportsMedicine and Orthopaedic Center, Cincinnati SportsMedicine Research and Education Foundation, Cincinnati, Ohio, U.S.A., Nolan J; Burkardt Consulting Center, Northern Kentucky University Department of Mathematics and Statistics, Highland Heights, Kentucky, U.S.A., Hasan SS; Mercy Health-Cincinnati SportsMedicine and Orthopaedic Center, Cincinnati SportsMedicine Research and Education Foundation, Cincinnati, Ohio, U.S.A.. Electronic address: s1663h@yahoo.com.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 May; Vol. 40 (5), pp. 1434-1442. Date of Electronic Publication: 2023 Nov 04.
DOI:	10.1016/j.arthro.2023.10.024
Abstrakt:	Purpose: To compare clinical and imaging results after repair of retracted large and massive full-thickness rotator cuff tears, including revision repairs, with and without augmentation with a bio-inductive collagen implant. Methods: The study group comprised 24 patients (17 male subjects) with retracted 2 or 3 tendon rotator cuff tears undergoing arthroscopic repair followed by onlay augmentation with a bio-inductive collagen implant. The control group comprised 24 patients (19 male subjects) matched by tear size undergoing repair without augmentation. Mean patient age at repair in both groups was 61 years. Active range of motion and patient-reported outcomes were recorded before and after surgery. Noncontrast high-field magnetic resonance imaging was obtained in 20 of 24 collagen implant patients and 17 of 24 control patients at minimum 6 months' follow-up to assess tendon healing. Results: American Shoulder and Elbow Surgeons and Simple Shoulder Test scores improved from 35 to 86 and 3.6 to 9.3, respectively, in the collagen implant group and from 39 to 87 and 3.9 to 9.7 in the control group. The visual analog score-pain improved from 6.0 to 0.9 and from 5.9 to 0.9 in the collagen implant and control groups, respectively (P < .001 for all). Overall improvements in range of motion and patient-reported outcomes were similar in both groups. Magnetic resonance imaging revealed intact repairs in 11 of 20 (55%) patients in the patch group and 9 of 17 (53%) in the control group. Two patients in each group were revised to reverse shoulder arthroplasty. Conclusions: Arthroscopic repair of retracted large and massive rotator cuff tears, including revision repairs, with and without augmentation using a bio-inductive collagen implant results in substantial and comparable early clinical improvement, although predictable healing remains elusive. Further work is needed to optimize patient selection for massive rotator cuff repair and define more precisely the indications for augmentation of these repairs using the collagen implant. Level of Evidence: Level III, retrospective cohort study. Competing Interests: Disclosures The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material. (Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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