Biomechanical effect of rotator cuff augmentation with an acellular dermal matrix graft: A cadaver study

Omae, Hiromichi; Steinmann, Scott P.; Zhao, Chunfeng; Zobitz, Mark E.; Wongtriratanachai, Prasit; Sperling, John W.; An, Kai Nan

doi:10.1016/j.clinbiomech.2012.05.001

Cited by 53 publications

(27 citation statements)

References 7 publications

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“…There are many reports regarding such procedures (Tocci et al, ; Bisson and Manohar, ; Grimberg et al, ; Lorbach et al, ; Kaplan et al, ; Jost et al, ). In addition, several studies have reported the effect of the materials used for rotator cuff repair (Beck et al, ; Omae et al, ; Friel et al, ). In this study, we demonstrated that the anterior sub‐region is stronger than the posterior and that the elastic properties differ between regions.…”

Section: Discussionmentioning

confidence: 99%

Tensile properties of a morphologically split supraspinatus tendon

et al. 2013

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The supraspinatus tendon consists morphologically of two sub-regions, anterior and posterior. The anterior sub-region is thick and tubular while the posterior is thin and strap-like. The purpose of this study was to compare the structural and mechanical properties of the anterior and posterior sub-regions of the supraspinatus tendon. The supraspinatus tendons from seven human cadaveric shoulders were morphologically divided into the anterior and posterior sub-regions. Length, width, and thickness were measured. A servo-hydraulic testing machine (MTS Systems Corporation, Minneapolis, MN) was used for tensile testing. The maximal load at failure, modulus of elasticity and ultimate tendon stress were calculated. Repeated measures were used for statistical comparisons. The mean anterior tendon cross-sectional area was 47.3 mm(2) and the posterior was 32.1 mm(2) . Failure occurred most often at the insertion site: anterior (5/7) and posterior (6/7). All parameters of the anterior sub-region were significantly greater than those of the posterior sub-region. The moduli of elasticity at the insertion site were 592.4 MPa in the anterior sub-region and 217.7 MPa in the posterior (P = 0.01). The ultimate failure loads were 779.2 N in the anterior sub-region and 335.6 N in the posterior (P = 0.003). The ultimate stresses were 22.1 MPa in the anterior sub-region and 11.6 MPa in the posterior (P = 0.008). We recognized that the anterior and posterior sub-regions of the SSP tendon have significantly different mechanical properties. In a future study, we need to evaluate how best to repair an SSP tendon considering these region-specific properties.

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Section: Discussionmentioning

confidence: 99%

Tensile properties of a morphologically split supraspinatus tendon

et al. 2013

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“…In routine repairs, a recent biomechanical analysis by van der Meijden et al 59 found that augmentation with a collagen patch did not influence biomechanical properties of a repair compared with double-row repair without augmentation or an intact tendon. Conversely, a biomechanical study of human dermal matrix grafts (GRAFTJACKET; Wright Medical Technology, Arlington, Tennessee) found that augmentation of single-row repair with this material had greater maximum load to failure than single-row repair without augmentation (mean, 560.2 N versus 345.7 N) 60 Platelet-Rich Plasma (PRP) With the recent increase in basic-science research related to PRP and its potential clinical benefits, its use in enhancing rotator cuff healing has been studied by several authors [66][67][68][69] . Results of current studies have not shown evidence of improved or accelerated functional outcomes or structural healing with the use of PRP augmentation in rotator cuff repairs.…”

Section: Structural Augmentationmentioning

confidence: 99%

Factors Affecting Rotator Cuff Healing

Mall¹,

Tanaka²,

Choi³

et al. 2014

Journal of Bone and Joint Surgery

186

154

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Several studies have noted that increasing age is a significant factor for diminished rotator cuff healing, while biomechanical studies have suggested the reason for this may be an inferior healing environment in older patients. Larger tears and fatty infiltration or atrophy negatively affect rotator cuff healing. Arthroscopic rotator cuff repair, double-row repairs, performing a concomitant acromioplasty, and the use of platelet-rich plasma (PRP) do not demonstrate an improvement in structural healing over mini-open rotator cuff repairs, single-row repairs, not performing an acromioplasty, or not using PRP. There is conflicting evidence to support postoperative rehabilitation protocols using early motion over immobilization following rotator cuff repair.

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“…A LightCycler FastStart DNA Master SYBR Green I kit (Roche) was used for RT‐PCR. The target sequences and a constitutively expressed housekeeping gene, glyceraldehyde‐3‐phosphate dehydrogenase ( GAPDH ), were amplified simultaneously using the primer sequences reported in previous studies …”

Section: Methodsmentioning

confidence: 99%

“…The target sequences and a constitutively expressed housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), 29 were amplified simultaneously using the primer sequences reported in previous studies. 25,30 Cell Tracking and Histology Two tendons in each group were used for tracking BMSC viability, 21 or 42 days after the repair, based on our previous protocol. 17 Briefly, BMSCs were labeled with Vybrant DiI cell-labeling solution (Molecular Probes, Waltham, MA) according to the manufacturer's instructions before seeding into the gels.…”

Section: Biomechanical Evaluationmentioning

confidence: 99%

Effects of lubricant and autologous bone marrow stromal cell augmentation on immobilized flexor tendon repairs

Zhao

Ozasa

Shimura

et al. 2015

Journal Orthopaedic Research

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The purpose of the study was to test a novel treatment that carbodiimide-derivatized-hyaluronic acid-lubricin (cd-HA-lubricin) combined cell-based therapy in an immobilized flexor tendon repair in a canine model. Seventy-eight flexor tendons from 39 dogs were transected. One tendon was treated with cd-HA-lubricin plus an interpositional graft of 8 × 105 BMSCs and GDF-5. The other tendon was repaired without treatment. After 21 day of immobilization, 19 dogs were sacrificed; the remaining 20 dogs underwent a 21-day rehabilitation protocol before euthanasia. The work of flexion, tendon gliding resistance, and adhesion score in treated tendons were significantly less than the untreated tendons (p < 0.05). The failure strength of the untreated tendons was higher than the treated tendons at 21 and 42 days (p < 0.05). However, there is no significant difference in stiffness between two groups at day 42. Histologic analysis of treated tendons showed a smooth surface and viable transplanted cells 42 days after the repair, whereas untreated tendons showed severe adhesion formation around the repair site. The combination of lubricant and cell treatment resulted in significantly improved digit function, reduced adhesion formation. This novel treatment can address the unmet needs of patients who are unable to commence an early mobilization protocol after flexor tendon repair.

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Biomechanical effect of rotator cuff augmentation with an acellular dermal matrix graft: A cadaver study

Cited by 53 publications

References 7 publications

Tensile properties of a morphologically split supraspinatus tendon

Tensile properties of a morphologically split supraspinatus tendon

Factors Affecting Rotator Cuff Healing

Effects of lubricant and autologous bone marrow stromal cell augmentation on immobilized flexor tendon repairs

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