October 06, 2015
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Biologic patch augmentation seen as safe, effective treatment for massive rotator cuff tears

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A retrospective analysis of prospectively collected data with a minimum 2-year follow-up indicates the efficacy of biologic patch augmentation for treatment of patients with massive rotator cuff tears.

“We found that biologic patch augmentation for massive rotator cuff tears with poor tendon quality was a safe and effective procedure,” Maximilian Petri, MD, said in his presentation at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress. “We had a failure rate of 19% over the course of 2 years, and the patients who did not fail had significant improvements in clinical outcomes scores.”

Twenty-one shoulders in 20 patients (with a mean age of 58 years) underwent patch-augmented rotator cuff repair performed by the senior author Peter J. Millett, MD, MSc. A bridging double-row technique was used and the repairs were augmented with acellular dermal patches made of collagen matrix impregnated with growth factors. Petri noted that 17 of the 21 shoulders were revisions of previously failed rotator cuff repairs.

“We had four failures of these 21 shoulders, equalizing 19%,” Petri said. “One patient obtained a reverse total shoulder arthroplasty, and three underwent revision rotator cuff repair.”

According to Petri, patients had significant improvements in their clinical scores and achieved a significant reduction in pain. Investigators found an 82.6% survivorship at 24 months after surgery.

“Eight out of 12 shoulders that obtained postoperative MRIs demonstrated abnormal findings on MRI,” Petri told Orthopedics Today. “Interestingly, this did not equate clinical failure, as only four patients were not satisfied with their results and underwent revision surgery. The correlation between findings on MRI and clinical success is not fully understood yet.”

“As a limitation, we were only able to obtain postoperative MRIs on 12 of 21 patients,” Petri told Orthopedics Today. “Besides the problem of the large catchment area of Dr. Millett’s practice, some patients did not return for repeated clinical and MRI follow-up, particularly if they were satisfied with their result.”

“The longer-term follow-up of these patients is of particular interest, and we will keep following this cohort,” Petri added. “We also now have a good number of patients who underwent patch augmented rotator cuff repair within the last 2 years, and we are waiting for their first minimum 2-year results as well. With a sufficiently sized cohort, an analysis for predictors of success or failure of patch-augmented rotator cuff repair is desirable.” – by Casey Tingle

Disclosure: Petri reports he received support from Arthrex.