Histologic Evaluation of Biopsy Specimens Obtained After Rotator Cuff Repair Augmented With a Highly Porous Collagen Implant

Arnoczky, Steven P.; Bishai, Shariff K.; Schofield, Brian; Sigman, Scott; Bushnell, Brandon D.; Hommen, Jan Pieter; Kampen, Craig Van

doi:10.1016/j.arthro.2016.06.047

Cited by 47 publications

(60 citation statements)

References 13 publications

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“…Following the animal experiments and the finite element studies, the porous collagen implant was used in humans to treat partial thickness cuff tears, and also as an augment to the treatment of full thickness cuff tears (11,24). Subsequent published tissue retrieval studies confirmed that the histological changes seen in human specimens corresponded precisely with the findings of the sheep study of Van Kampen et al (23,25). Use of the collagen implant as an alternative to completion of the tear and performing a repair has the advantage of requiring only 1 week in a sling and return to unrestricted activities at 6 weeks postoperative.…”

Section: Discussionmentioning

confidence: 96%

Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: a 5-year clinical and MRI follow-up

Bokor¹,

Sonnabend

Deady³

et al. 2019

Muscle Ligaments and Tendons J

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Background. The purpose of this study was to review patients with intermediate-and high-grade partial-thickness rotator cuff tears at 5 years following insertion of a highly-porous collagen implant on the bursal surface of the cuff to determine the durability of the clinical results and structural integrity of the healed tendons compared to their previously reported 2-year results. Methods. Eleven of the original 13 patients were examined after 5 years. Clinical scores (Constant and ASES) and MRI evaluations of tendon integrity and quality were compared to the two-year results. Results. All patients demonstrated statistically significant improvement in clinical scores compared to preoperative values. Mean Constant and ASES pain and function scores improved at 5 years but were not statistically different from the two-year scores. Eight of the 11 patients demonstrated no negative change in tendon quality on MRI. However, 3 patients had developed new, asymptomatic tears (1 low-grade articular, 2 low-grade intra-substance) of the supraspinatus tendon. Conclusions. This 5-year follow-up confirms the ongoing clinical benefit of this implant in the treatment of partial-thickness lesions of the rotator cuff and demonstrates ongoing structural tendon improvement, with most repaired tendons intact at five years.

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Section: Discussionmentioning

confidence: 96%

Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: a 5-year clinical and MRI follow-up

Bokor¹,

Sonnabend

Deady³

et al. 2019

Muscle Ligaments and Tendons J

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show abstract

“…Histology from both sheep and human studies has shown the ability of a lyophilized, reconstituted, and lightly crosslinked collagen implant of high porosity to undergo reorganization 5 weeks after implantation to augment a rotator cuff repair [ 5 , 6 ]. After 3 months, additional collagen was seen on top of the implant again in both sheep and humans; at 6 months, there were no traces of the implant in the rotator cuff tissue biopsied, and new tissue resembling native tendon was in its place [ 5 , 6 ]. Other attempts at tendon in situ regeneration to jump start cell-scaffold interactions prior to implantation have shown supporting results.…”

Section: Collagen Scaffoldsmentioning

confidence: 99%

The Role of Collagen-Based Biomaterials in Chronic Wound Healing and Sports Medicine Applications

Yeung¹,

Kelly²

2021

Bioengineering

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Advancements in tissue engineering have taken aim at treating tissue types that have difficulty healing naturally. In order to achieve improved healing conditions, the balance of exogenous matrix, cells, and different factors must be carefully controlled. This review seeks to explore the aspects of tissue engineering in specific tissue types treated in sports medicine and advanced wound management from the perspective of the matrix component. While the predominant material to be discussed is collagen I, it would be remiss not to mention its relation to the other contributing factors to tissue engineered healing. The main categories of materials summarized here are (1) reconstituted collagen scaffolds, (2) decellularized matrix tissue, and (3) non-decellularized tissue. These three groups are ordered by their increase in additional components beyond simply collagen.

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“…Smith et al [53•] recommend that future grafts should aim to combine the macro mechanical properties of synthetic grafts with the micro mechanical properties of the biologic scaffolds. Another study used a second arthroscopic procedure to biopsy the repair site of rotator cuff repairs augmented with bovine collagen matrix [54]. By obtaining the seven specimens at different time points, the authors were able to outline a timeline of graft incorporation.…”

Section: Patches and Augmentsmentioning

confidence: 99%

“…By obtaining the seven specimens at different time points, the authors were able to outline a timeline of graft incorporation. Host cell infiltration with the presence of fibroblasts was seen in the earliest sample at 5 weeks, increasing organization was noted at 3 months, and finally full incorporation with solely host tissue seen at 6 months [54]. Beitzel et al [55] tried to evaluate if the type of graft impacted the response of mesenchymal cells in a repair.…”

Section: Patches and Augmentsmentioning

confidence: 99%

The Role of Biologic Therapy in Rotator Cuff Tears and Repairs

Charles

Christian

Cole

2018

Curr Rev Musculoskelet Med

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Platelet-rich plasma (PRP) overall has no significant impact on functional outcomes and repair integrity, but may be more advantageous in small to medium tears. Further studies should focus on leukocyte-rich versus poor preparations and the use of PRP in patients that are high risk for repair failure. Biologic and synthetic patches or augments provide mechanical stability for large and massive rotator cuff tears and decrease re-tear rates. Mesenchymal stem cells have demonstrated improved healing rates without an impact on outcomes. Cytokines and growth factors show promise in animal models, but require human trials to further evaluate. In massive or revision repairs, allograft or synthetic patch augmentation should be considered. Platelet-rich plasma may have benefit in smaller tears. Further studies are needed to evaluate the value of mesenchymal stem cells and various cytologic chemical signals.

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Histologic Evaluation of Biopsy Specimens Obtained After Rotator Cuff Repair Augmented With a Highly Porous Collagen Implant

Cited by 47 publications

References 13 publications

Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: a 5-year clinical and MRI follow-up

Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: a 5-year clinical and MRI follow-up

The Role of Collagen-Based Biomaterials in Chronic Wound Healing and Sports Medicine Applications

The Role of Biologic Therapy in Rotator Cuff Tears and Repairs

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