Conventional Rotator Cuff Repair Research Articles

Effect of Bone Marrow Stimulation on Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis.

Arthroscopic rotator cuff repair (RCR) is a common orthopaedic procedure, but it has a high rate of retears that can negatively affect the functional outcomes. Bone marrow stimulation (BMS) has been suggested as an additional treatment to improve the outcomes of RCR. To compare the effectiveness of the BMS procedure during RCR with conventional RCR. Systematic review; Level of evidence, 2. A systematic literature search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, and Scopus, on March 1, 2023, for studies comparing postoperative retear rates and functional outcomes between patients who underwent primary arthroscopic RCR with and without the BMS procedure. Only level 1 and 2 randomized controlled trials with a minimum 12-month follow-up were included. The primary outcomes were retear rates and functional outcomes as measured by the Constant; American Shoulder and Elbow Surgeons (ASES); and University of California, Los Angeles (UCLA) scores and by postoperative range of motion. Subgroup analyses were performed based on repair technique (single-row repair vs double-row or suture-bridge repair). The standardized mean difference (SMD) and odds ratio (OR) were utilized to synthesize continuous and dichotomous outcomes, respectively. Homogeneity was evaluated using the chi-square test and I2 statistic. The literature search yielded 661 articles, of which 6 studies (522 patients; 261 with BMS, 261 without BMS) met the eligibility criteria. The combined analysis showed no significant decrease in retear rates with the utilization of the BMS procedure during RCR (OR, 0.60; 95% CI, 0.35 to 1.03; P = .07; I2 = 24%). There was no significant intergroup difference in functional outcomes (Constant score: SMD, 0.13; 95% CI, -0.04 to 0.31; P = .13; I2 = 0%; ASES score: SMD, 0.04; 95% CI, -0.20 to 0.28; P = .73; I2 = 0%; UCLA score: SMD, -0.13; 95% CI, -0.50 to 0.23; P = .47; I2 = 0%). Subgroup analyses revealed no significant differences in postoperative retear risk or total Constant score according to the repair technique. Based on the available evidence, this systematic review did not find a significant benefit of the BMS procedure at the footprint during arthroscopic RCR compared with conventional RCR in terms of retear rates and functional outcomes at short-term follow-up.

EE124 Return to Work Following Rotator Cuff Repair Surgery in the U.S.

Rotator cuff repair (RCR) surgery is associated with a lengthy recovery period, resulting in productivity loss. This analysis aims to review the return to work (RTW) duration following conventional RCR in the literature and compare it to the RTW outcomes with a novel Bioinductive Implant∗.

Nanofiber Scaffolds by Electrospinning for Rotator Cuff Tissue Engineering.

Rotator cuff tears continue to be at risk of retear or failure to heal after surgical repair, despite the use of various surgical techniques, which stimulate development of novel scaffolding strategies. They should be able to address the known causes of failure after the conventional rotator cuff repair: (1) failure to reproduce the normal tendon healing process, (2) resultant failure to reproduce four zones of the enthesis, and (3) failure to attain sufficient mechanical strength after repair. Nanofiber scaffolds are suited for this application because they can be engineered to mimic the ultrastructure and properties of the native rotator cuff tendon. Among various methods for tissue-engineered nanofibers, electrospinning has recently been highlighted in the rotator cuff field. Electrospinning can create fibrous and porous structures that resemble natural tendon's extracellular matrix. Other advantages include the ability to create relatively large surface-to-volume ratios, the ability to control fiber size from the micro to the nano scale, and the flexibility of material choices. In this review, we will discuss the anatomical and mechanical features of the rotator cuff tendon, their potential impacts on improper healing after repair, and the current knowledge of the use of electrospinning for rotator cuff tissue engineering.

Relationship of Acromial Morphology and Rotator Cuff Integrity

The influence of individual acromial morphology on the pathogenesis of rotator cuff tears remains controversial. Since Neer first described the impingement syndrome, several authors have described the morphology of the acromion. In this study, we try to find a physiopathological correlation between the anatomical morphology of the acromion based on these two recently descripted parameters (Acromial index and Critical Shoulder Angle) and rotator cuff tears. Thirty-six consecutive conventional rotator cuff repair patients were retrospectively reviewed at our institution. Standardized, true anteroposterior radiographs with the arm in the neutral position were used to assess the acromion index, and the critical shoulder angle according. On standardized outlet views, the acromion morphology was classified according to Bigliani and Morrison. The acromion was flat in 2 patients (6%), curve (type 2) in eight patients, and hooked. The mean acromial index was 0.7. The mean critical shoulder angle was 37°. Acromial morphology plays without any doubt an important role in the pathogenesis impingement and its evolution to cuff rotator tears. The results of our study confirm the importance of a more comprehensive evaluation of the morphology of the acromion, which take in consideration not only acromial shape, but especially its lateral extension evaluated by the acromial index and the critical angle of the shoulder.

Rotator Cuff Repair: Is there any role for acromioplasty?

ABSTRACTObjectives: Acromioplasty has been one of the most common techniques amongst orthopedic surgeries in the past decade. However, its efficacy in arthroscopic surgeries of rotator cuff repair is still debatable. The purpose of this study is to compare the arthroscopic rotator cuff repair with or without acromioplasty in patients with complete rotator cuff tear.Methods: In this prospective cohort study, patients with complete rotator cuff tear (acromion type II or III Bigliani) and a history of failure to the conservative treatment for at least 6 months were evaluated for eligibility. Patients, based on the time interval, were placed in one of two groups: arthroscopic rotator cuff repair with (RCR-A group) and without acromioplasty (RCR group). Patients were assessed for two years in term of pain intensity by VAS criteria and shoulder functional status by Quick-DASH, Constant score and simple shoulder test criteria.Results: In the baseline assessment, RCR-A group (34 patients) and RCR group (33 patients) were similar. Comparing patients in two groups in relation to SST, Quick-DASH and VAS scores preoperatively showed there is no significant difference between the two groups. The SST, Quick-DASH and VAS scores improved significantly in both groups at both the 6-month and 2-year follow-ups (all P < 0.001). The extent of progress in the functional scores was similar in both groups (P > 0.05).Conclusion: Arthroscopic rotator cuff repair without acromioplasty may be as reliable and useful as conventional rotator cuff repair with acromioplasty. Thus, acromioplasty cannot be recommended as a routine technique in every rotator cuff repair.