Orthopedic Applications of Acellular Human Dermal Allograft for Shoulder and Elbow Surgery

Acevedo, Daniel Camilo Aguirre; Shore, Brett; Mirzayan, Raffy

doi:10.1016/j.ocl.2015.02.006

Cited by 33 publications

(16 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, the use of GraftJacket to extend the LDT has not been reported. Similar to our case, Petri et al [ 12 ] described lengthening of a LDT using another brand of acellular dermal matrix (ArthroFlex patch) [ 18 ].…”

Section: Discussionsupporting

confidence: 66%

See 1 more Smart Citation

Latissimus Dorsi Tendon Transfer with GraftJacket® Augmentation to Increase Tendon Length for an Irreparable Rotator Cuff Tear

Skedros

Henrie

2017

Case Reports in Orthopedics

View full text Add to dashboard Cite

Massive irreparable rotator cuff tears can be reconstructed with latissimus dorsi tendon transfers (LDTT). Although uncommon, the natural length of the latissimus dorsi tendon (LDT) could be insufficient for transfer even after adequate soft tissue releases. Descriptions of cases where grafts were needed to lengthen the LDT are therefore rare. We located only two reports of the use of an acellular dermal matrix to increase effective tendon length in tendon transfers about the shoulder: (1) GraftJacket patch for a pectoralis major tendon reconstruction and (2) ArthroFlex® patch for LDTT. Both of these brands of allograft patches are obtained from human cadavers. These products are usually used to cover soft tissue repairs and offer supplemental support rather than for increasing tendon length. Extending the LDTT with GraftJacket to achieve adequate length, to our knowledge, has not been reported in the literature. We report the case of a 50-year-old male who had a massive, irreparable left shoulder rotator cuff tear that was reconstructed with a LDTT. The natural length of his LDT was insufficient for transfer. This unexpected situation was rectified by sewing two patches of GraftJacket to the LDT. The patient had greatly improved shoulder function at two-year follow-up.

show abstract

Section: Discussionsupporting

confidence: 66%

“…The patch used in that case was a 3 mm ArthroFlex patch (a brand of human acellular dermal matrix). This product is usually used to cover soft tissue repairs and offer supplemental support rather than for increasing their length [ 16 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Latissimus Dorsi Tendon Transfer with GraftJacket® Augmentation to Increase Tendon Length for an Irreparable Rotator Cuff Tear

Skedros

Henrie

2017

Case Reports in Orthopedics

View full text Add to dashboard Cite

show abstract

“…This work focuses on acellular dermal allografts; these grafts were initially used as wound cover in burns and other large wounds [4]; however, they are now also finding numerous other clinical applications as a scaffold allowing for new tissue ingrowth: it is the case of wound healing (diabetic ulcers or burns), tendon and ligament repair [5], soft-tissue supplementation [6], and joint resurfacing [7]. Methods of decellularization can have different processing times and they can employ different means, eventually producing alterations of the matrix structure; the most common processes include a combination of physical, chemical, and enzymatic agents.…”

Section: Introductionmentioning

confidence: 99%

Ex Vivo Dermis Mechanical Behavior in Relation to Decellularization Treatment Length

Terzini¹,

Bignardi²,

Castagnoli³

et al. 2016

TOBEJ

View full text Add to dashboard Cite

Background:The dermis is a commonly used source tissue for biologic scaffolds; all cellular and nuclear materials need to be removed to limit the inflammatory immune response by the host organism. The decellularization is critical because it must preserve the structural integrity of the extracellular matrix. This work has analyzed a decellularization procedure commonly followed for the dermal tissue that is a chemical treatment with sodium hydroxide. The goal of this work is to identify the optimal treatment length on the basis of structural properties.Methods:Tensile tests have been performed on the native tissue and on tissues decellularized for 1-7 weeks in sodium hydroxide. The collected data have been analyzed through Tukey-Kramer test to assess if the mechanical properties (ultimate tensile stress and elastic modulus) of decellularized tissues were significantly different from the properties of the native tissue. These tests have been performed on specimens cut along two orthogonal directions (parallel and perpendicular to Langer’s lines).Results:The decellularization treatment performed with sodium hydroxide in general weakens the tissue: both the ultimate stress and the elastic modulus get lower. The structural properties along Langer lines orientation are more strongly impacted, while the structural properties orthogonal to Langer lines can be preserved with an optimal duration of the decellularization treatment that is 5-6 weeks.Conclusion:The duration of the decellularization treatment is critical not only to reach a complete decellularization, but also to preserve the mechanical properties of the tissue; 5-6 week treatment performed with sodium hydroxide allows preserving the mechanical properties of the native tissue perpendicularly to Langer lines orientation, and minimizing the impact of the decellularization process on the mechanical properties along the Langer lines orientation.

show abstract

“…Although the review articles suggested that dermal graft has good biomechanical properties and rhBMP-2 is effective for biological augmentation in bone-tendon, there was no original article that showed the composite of rhBMP-2 and an acellular dermal graft [35,36]. For this initial study on rhBMP-2-coated dermal graft for rotator cuff repair, we generated a rabbit rotator cuff injury model by using a silicon tube, which covers the supraspinatus tendon that was detached from the humeral bone for 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

rhBMP-2-Coated Acellular Dermal Graft for Chronic Rotator Cuff Healing: Translational Tendon Repair Research

Lee¹,

Jang²,

Lee³

2019

Biotechnology and Bioengineering

View full text Add to dashboard Cite

A rotator cuff tear is a common shoulder injury in sports medicine. However, a rotator cuff repair still has the high failure rate (57%) in large torn (>8 cm 2) rotator cuff cases. One of the main reasons is failing at suture-tendon cause of continuous tensional and torsional stresses even after surgery, and thus, an ideal biologic augmentation to overcome large tears is an essential challenge. The ECM graft, the biological material can be useful for augment repair of large torn rotator cuff. Recombinant human bone morphogenetic protein 2 (rhBMP-2), which belongs to transforming growth factor-β superfamily, is well known as an osteoinductive growth factor. It plays an important role in the development of bone and cartilage. rhBMP-2 also facilitates chemotaxis in the host tissue. In this study, rhBMP-2coated acellular dermal graft, which is isolated from human cadaveric donor, was transplanted in the rabbit with the chronic rotator cuff injury. The radiologic image, histomorphometric, histologic image analyses, and tensile test were performed to evaluate the effectiveness. The results showed the enhancement of increased host cell infiltration, new bone formation, and tensile mechanical property. The rhBMP-2-coated acellular dermal graft will be promising for chronic rotator cuff healing.

show abstract

Orthopedic Applications of Acellular Human Dermal Allograft for Shoulder and Elbow Surgery

Cited by 33 publications

References 41 publications

Latissimus Dorsi Tendon Transfer with GraftJacket® Augmentation to Increase Tendon Length for an Irreparable Rotator Cuff Tear

Latissimus Dorsi Tendon Transfer with GraftJacket® Augmentation to Increase Tendon Length for an Irreparable Rotator Cuff Tear

Ex Vivo Dermis Mechanical Behavior in Relation to Decellularization Treatment Length

rhBMP-2-Coated Acellular Dermal Graft for Chronic Rotator Cuff Healing: Translational Tendon Repair Research

Contact Info

Product

Resources

About