Excellent healing rates and patient satisfaction after arthroscopic repair of medium to large rotator cuff tears with a single-row technique augmented with bone marrow vents

Dierckman, Brian D.; Ni, Jake; Karzeł, Ronald P.; Getelman, Mark H.

doi:10.1007/s00167-017-4595-6

Cited by 33 publications

(36 citation statements)

References 64 publications

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“…Other studies have described results using the single-row fashion in cuff repair. 9,24,27 Snyder and Burns 31 indicated that the uncovered bone marrow droplets would flow from the vents and form the crimson duvet, covering the repaired rotator cuff. However, Yoon et al 37 proposed that the uncovered footprint may not maintain bone marrow droplets, which would subsequently vanish into the subacromial space.…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage

et al. 2020

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Background: There is no research on incomplete footprint coverage with single-row repair related to bone marrow stimulation (BMS) in large to massive rotator cuff tears (RCTs). Purpose/Hypothesis: The purpose was to compare the clinical results and structural integrity between BMS and non-BMS groups that underwent arthroscopic repair of large to massive rotator cuff tears with <50% footprint coverage. It was hypothesized that both groups would exhibit improved clinical outcomes at 2 years after surgery but the BMS group would have significantly better clinical outcomes and structural integrity. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 98 patients who underwent arthroscopic repair with <50% footprint coverage for large to massive RCTs with (BMS group; n = 56) or without (non-BMS group; n = 42) BMS. Functional outcomes at the 2-year follow-up were assessed using the visual analog scale for pain score, subjective shoulder value; American Shoulder and Elbow Surgeons score; University of California, Los Angeles, shoulder score; and active range of motion. Structural integrity was evaluated using magnetic resonance arthrography or computed tomography arthrography results at 6 months postoperatively. Results: At the 2-year follow-up, all functional outcomes significantly improved in both groups compared with preoperative values ( P < .001). However, there were no significant postoperative differences between groups. On follow-up magnetic resonance arthrography or computed tomography arthrography, the overall retear rate was not significantly different between the BMS group (30.3%; 17/56) and the non-BMS group (35.7%; 15/42). Conclusion: While both groups exhibited functional improvement after single-row repair with <50% footprint coverage for large to massive RCTs, BMS did not produce better clinical outcomes or structural integrity.

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Section: Discussionmentioning

confidence: 99%

Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage

et al. 2020

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“…Unlike conventional SR, Dierckman et al and Dini and Snyder reported that arthroscopic rotator cuff repair using a single-row technique (also referred to as “Southern California Orthopedic Institute [SCOI] row”) consisting of medially-based, triple-loaded anchors augmented with bone marrow vents in the rotator cuff footprint lateral to the repair results in > 90% healing rates and excellent patient reported clinical outcomes [ 14 , 15 ]. They proposed that a single row with three sutures per anchor yields the strongest possible repair with the least possible tension on the construct; however, verification of such an advantage based on biomechanical studies is limited.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison between single-row with triple-loaded suture anchor and suture-bridge double-row rotator cuff repair

et al. 2020

BMC Musculoskelet Disord

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Background Numerous biomechanical and clinical studies comparing different techniques for rotator cuff repair have been reported, yet universal consensus regarding the superior technique has not achieved. A medially-based single-row with triple-loaded suture anchor (also referred to as the Southern California Orthopedic Institute [SCOI] row) and a suture-bridge double-row (SB-DR) with Push-Locks have been shown to result in comparable improvement in treating rotator cuff tear, yet the biomechanical difference is unknown. The purpose of the current study was to determine whether a SCOI row repair had comparable initial biomechanical properties to a SB-DR repair. Methods Six matched pairs of fresh-frozen cadaveric shoulders with full-thickness supraspinatus tendon tears we created were included. Two different repairs were performed for each pair (SCOI row and SB-DR methods). Specimens were mounted on a material testing machine to undergo cyclic loading, which was cycled from 10 to 100 N at 1 Hz for 500 cycles. Construct gap formation was recorded at an interval of 50 cycles. Samples were then loaded to failure and modes of failure were recorded. Repeated-measures analysis of variance and pair-t test were used for statistical analyses. Results The construct gap formation did not differ between SCOI row and SB-DR repairs (P = 0.056). The last gap displacement was 1.93 ± 0.37 mm for SCOI row repair, and 1.49 ± 0.55 mm for SB-DR repair. The tensile load for 5 mm of elongation and ultimate failure were higher for SCOI row repair compared to SB-DR repair (P = 0.011 and 0.028, respectively). The ultimate failure load was 326.34 ± 11.52 N in the SCOI row group, and 299.82 ± 27.27 N in the SB-DR group. Rotator cuff repair with the SCOI row method failed primarily at the suture- tendon interface, whereas pullout of the lateral row anchors was the primary mechanism of failure for repair with the SB-DR method. Conclusion Rotator cuff repair with the SCOI row method has superior biomechanical properties when compared with the SB-DR method. Therefore, SCOI row repair using a medially-based single-row technique with triple-loaded suture anchor is recommended to improve the initial strength in treating full-thickness rotator cuff tears.

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“…27,29,32,36,41 Bone marrow vents have shown promise in improving the bone-tissue interface healing of many soft tissue injuries by allowing autologous marrow-derived cells to reach the repair site. 9,37 Bone marrow venting is a comparatively expeditious surgical procedure, has no issue of cellular incompatibility, and may be accomplished through vented tissue anchors or through separate bone puncture holes. 9,46 Potential problems with bone puncture holes for bone marrow venting is that it can weaken the bone around the venting holes, possibly leading to inadequate anchor fixation in the bone.…”

mentioning

confidence: 99%

“…9,37 Bone marrow venting is a comparatively expeditious surgical procedure, has no issue of cellular incompatibility, and may be accomplished through vented tissue anchors or through separate bone puncture holes. 9,46 Potential problems with bone puncture holes for bone marrow venting is that it can weaken the bone around the venting holes, possibly leading to inadequate anchor fixation in the bone. 37 Scaffolds or ''patches'' have also shown value for augmenting torn tissue and promoting tissue thickening.…”

mentioning

confidence: 99%

A prospective study comparing tendon-to-bone interface healing using an interposition bioresorbable scaffold with a vented anchor for primary rotator cuff repair in sheep

Easley

Puttlitz

Hackett

et al. 2020

Journal of Shoulder and Elbow Surgery

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Background: The purpose of this study was to evaluate the biomechanical and histologic properties of rotator cuff repairs using a vented anchor attached to a bioresorbable interpositional scaffold composed of aligned PLGA (poly(L-lactide-co-glycoside)) microfibers in an animal model compared to standard anchors in an ovine model. Methods: Fifty-six (n ¼ 56) skeletally mature sheep were randomly assigned to a repair of an acute infraspinatus tendon detachment using a innovative anchor-PLGA scaffold device (Treatment) or a similar anchor without the scaffold (Control). Animals were humanely euthanized at 7 and 12 weeks post repair. Histologic and biomechanical properties of the repairs were evaluated and compared. Results: The Treatment group had a significantly higher fibroblast count at 7 weeks compared to the Control group. The tendon bone repair distance, percentage perpendicular fibers, new bone formation at the tendon-bone interface, and collagen type III deposition was significantly greater for the Treatment

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Excellent healing rates and patient satisfaction after arthroscopic repair of medium to large rotator cuff tears with a single-row technique augmented with bone marrow vents

Abstract: IV.

Cited by 33 publications

References 64 publications

Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage

Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage

Biomechanical comparison between single-row with triple-loaded suture anchor and suture-bridge double-row rotator cuff repair

A prospective study comparing tendon-to-bone interface healing using an interposition bioresorbable scaffold with a vented anchor for primary rotator cuff repair in sheep

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