Commercially available extracellular matrix materials for rotator cuff repairs: State of the art and future trends

Twenty‐five years of tendon and ligament research

“…Recently, rotator cuff augmentation with extracellular matrix-derived scaffold materials has received attention from researchers, clinicians, and industry. 104 Currently, allograft and xenograft materials are widely available, originating from human fascia lata, porcine small intestine submucosa, equine pericardium, and multiple sources of dermis. [105][106][107] As repair augments, these grafts have been used to enhance tissue healing while temporarily providing mechanical support.…”

“…108,109 Current research has demonstrated a potential positive role for these products; however, additional research will be required before they are incorporated into routine use. 104 Throughout the past 25 years, researchers have studied natural healing and focused on how this process can be improved. Both chemical and mechanical factors have been shown to play important roles in healing.…”

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

“…Rotator cuff repair with devices derived from polylactic acid [26][27][28] , polytetrafluoroethylene 29 , extracellular matrix [30][31][32][33][34][35] , chitin 36 , and chitosanhyaluronan 37 have been studied in animal models over the past decade. Of these, only extracellular matrix derived from dermis, small intestine submucosa, fascia lata, and pericardium are commercially available for rotator cuff repair at the current time 38 . 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] .…”

“…Of these, only extracellular matrix derived from dermis, small intestine submucosa, fascia lata, and pericardium are commercially available for rotator cuff repair at the current time 38 . 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] .…”

The biomechanical role of scaffolds in augmented rotator cuff tendon repairs

“…Currently, scaffolds derived from various natural and synthetic biomaterials are being marketed as augmentation devices for rotator cuff repairs at the time of 3,9,10 surgery.…”