Microfractures at the rotator cuff footprint: a randomised controlled study

Abstract

Purpose Microfractures at the footprint may be a potential additional source of growth factor and enhance the tendon healing at the bone-tendon junction when repairing rotator cuff tears. Methods Fifty-seven patients who underwent shoulder arthroscopy for repair of complete rotator cuff tears were randomly divided into two groups, using a block randomisation procedure. Patients underwent microfracture at the footprint in the treatment group. The patients in the control group (n=29) did not receive that treatment. All patients had the same post-operative rehabilitation protocol. Results The two groups were homogeneous. There was a significant improvement from baseline to the last minimum follow-up of two years. At three months from the index procedure, visual analogue scale (VAS), range of motion (ROM) and University of California at Los Angeles (UCLA) and Constant scores were significantly better in group 1 than in group 2 (P<.05). At the last follow-up (minimum two years), clinical and functional outcomes were further improved in both the groups but inter-group differences were not significant. No technique-related complications were recorded. Conclusions Microfractures at the footprint are simple, safe, inexpensive and effective at producing less pain in the short term in patients who undergo rotator cuff repair, but at two years they do not result in significantly different outcomes, either clinically or at imaging, compared to traditional rotator cuff repair.

Safety and efficacy of treating symptomatic, partial-thickness rotator cuff tears with fresh, uncultured, unmodified, autologous adipose-derived regenerative cells (UA-ADRCs) isolated at the point of care: a prospective, randomized, controlled first-in-human pilot study

“…Some authors proposed bone marrow stimulation by drilling of holes into the proximal humerus at the footprint of arthroscopic rotator cuff repair [58][59][60]. However, the real benefit of these procedures in which mesenchymal stem cells (MSCs) may serve to augment arthroscopic rotator cuff repair rather than the only therapy has yet to be demonstrated (c.f [23].).…”

Pulsed Electromagnetic Fields After Rotator Cuff Repair: A Randomized, Controlled Study

“…2 Microfractures at the footprint may favor healing and integration of the repaired rotator cuff tendon to the bone, with better short-term outcomes compared with arthroscopic repair alone. 6 The goal of the current study was to assess the effect of pulsed electromagnetic fields after rotator cuff repair. Application of pulsed electromagnetic fields has been successfully used as an adjuvant to standard postoperative protocols after knee, [7][8][9] ankle, 10 and hip 11 surgery to reduce local inflammation, postoperative joint swelling, and recovery time, as well as to provide pain relief.…”

Arthroscopic debridement of the ankle for mild to moderate osteoarthritis: a midterm follow-up study in former professional soccer players

“…In advanced osteoarthritis, in the midterm, microfractures do not affect the outcomes [ 25 ]. Nevertheless, they decrease the risk of clinical failure, and improve the outcomes compared to debridement alone [ 26 ]. Therefore, it is essential to address associated intra-articular lesions, present in up to 72 % of patients [ 27 , 28 ], and predictive of poor results.…”