An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears

Badhe, Sachin; Lawrence, Tom; Smith, Francis Duval; Lunn, P. G.

doi:10.1016/j.jse.2007.08.005

Cited by 208 publications

(159 citation statements)

References 20 publications

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“…However, in their current configurations, commercially available extracellular matrices may possess some, but likely not all, of the mechanical and suture retention properties necessary for providing effective mechanical augmentation to rotator cuff repairs [38][39][40] . Despite the current clinical use of extracellular matrices for rotator cuff repair, the limited clinical data show mixed results with regard to surgical outcomes and complication rates [41][42][43][44][45][46][47][48][49] . In particular, several clinical studies investigating small intestine submucosa have found high retear rates, formation of noninfectious edema, swelling, pain, and increased skin temperature around the wound [42][43][44][45] , which have led to the conclusion that small intestine submucosa is not suitable for rotator cuff repair, at least in its current form 45 .…”

mentioning

confidence: 99%

Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Derwin

Codsi

Milks

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

143

129

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mentioning

confidence: 99%

Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Derwin

Codsi

Milks

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

143

129

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“…Badhe et al reported good results 4.5 years after augmenting massive rotator cuff tears in 10 patients, with an intact repair in eight patients and a retear in only two patients. 23 Soler et al on the other hand were using Permacol as a bridging device. 24 All four reconstructions failed within 6 months postoperatively and had signs of inflammation.…”

Section: Xenograftsmentioning

confidence: 99%

Biologics in rotator cuff surgery

2014

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Pathologies of the rotator cuff are by far the most common cause of shoulder dysfunction and pain. Even though reconstruction of the rotator cuff results in improved clinical outcome scores, including decreased pain, several studies report high failure rates. Orthopaedic research has therefore focused on biologically augmenting the rotator cuff reconstruction and improving tendon-bone healing of the rotator cuff. This biological augmentation has included the application of different platelet concentrates containing growth factors, mesenchymal stem cells, scaffolds and a combination of the above. The present review provides an overview over the biological augmentation options based upon current evidence.

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“…8 With the advent of extracellular matrix scaffolds, new treatment strategies have evolved to address both the technical, mechanical and biological healing difficulties associated with primary repair of massive rotator cuff tears. 1,17,21 Prior studies evaluating the efficacy of porcine xenografts to augment rotator cuff tears have had varied results. Badhe et al evaluated the clinical outcome of the ZCR TM patch porcine dermal scaffold (Zimmer Inc, Warsaw, IN) used as an augmentation in 10 patients with massive rotator cuff tears.…”

Section: Dojmentioning

confidence: 99%

“…Imaging studies demonstrated intact grafts in eight of the 10 patients. 1 Walton et al evaluated the Restore TM subintestinal mucosa (SIS) patch (DePuy Orthopaedics, Warsaw, IN) for rotator cuff augmentation in a prospective, randomized controlled trial. The Restore TM group had a higher failure rate and lower Overall outcomes and the ability of the rotator cuff to heal, however, can be inversely correlated to the size and amount of retraction of tears as well as the amount of tension applied to the repair.…”

Section: Dojmentioning

confidence: 99%

Management of Massive Rotator Cuff Tears in Active Patients with Minimal Glenohumeral Arthritis: A Prospective Observational Study with Clinical and Radiographic Analyses of Reconstruction using Dermal Tissue Matrix Xenograft

Toth¹,

Gupta²

2013

The Duke Orthopaedic Journal

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Objectives: To evaluate the clinical and radiographic outcomes of patients undergoing interposition reconstruction of massive, otherwise irreparable rotator cuff tears through a mini-open approach with the use of a porcine dermal tissue matrix. Materials and methods:We performed a prospective observational study of 26 patients (27 shoulders) who underwent reconstruction of massive rotator cuff tears using dermal tissue matrix xenograft. Pain level (scale 0-10, 10 = severe pain), active range of motion, and supraspinatus and external rotation strength were assessed. Additional outcome measures included modified American shoulder and elbow score (MASES) and short form-12 (SF-12) score. Clinical and radiographic analyses were performed at an average 32 months follow-up period (minimum 2-year follow-up). Ultrasound imaging (static and dynamic) of the operative shoulder was performed at final followup to assess the integrity of the reconstruction.Results: Mean patient age was 60. Mean pain level decreased from 5.1 to 0.4 (p = 0.002). Mean active forward flexion, abduction, and external rotation motion improved from 138.8 to 167.3 (p = 0.024), 117.9 to 149.3 (p = 0.001) and 57.7 to 64.7°( p = 0.31), respectively. Supraspinatus and external rotation strength improved from 7.2 to 9.4 (p = 0.001) and 7.4 to 9.5 (p = 0.001), respectively. Mean MASES improved from 62.7 to 91.8 (p = 0.0007) and mean SF-12 scores improved from 48.4 to 56.6 (p = 0.044). Twenty-one patients (twenty-two shoulders) returned for a dynamic and static ultrasound of the operative shoulder at a minimum 2-year follow-up. Sixteen (73%) demonstrated a fully intact tendon/graft reconstruction. Five (22%) patients had partially intact reconstructions, and one (5%) had a complete tear at the graft-bone interface due to suture anchor pullout as a result of a fall. There were no cases of infection or tissue rejection. Conclusion:We present a reproducible surgical technique for the management of massive irreparable rotator cuff tears. In our series, patients demonstrated a significant improvement in both subjective and objective clinical outcomes. Radiographic analysis demonstrated that the majority of patients had a fully intact reconstruction at a minimum 2-year follow-up.

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An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears

Cited by 208 publications

References 20 publications

Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Biologics in rotator cuff surgery

Management of Massive Rotator Cuff Tears in Active Patients with Minimal Glenohumeral Arthritis: A Prospective Observational Study with Clinical and Radiographic Analyses of Reconstruction using Dermal Tissue Matrix Xenograft

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