Retears and complication rates after arthroscopic rotator cuff repair with scaffolds: a systematic review
The goal of repairing rotator cuff injuries is an anatomical procedure without tension repair. Considering the high percentage of re-rupture after large and massive lesions repair, numerous surgical solutions have been proposed. The purpose of this systematic review was to present retears and complication rates following arthroscopic treatment of rotator cuff pathology with scaffolds. A systematic review of the existing literature was performed to identify all studies dealing with arthroscopic rotator cuff repair using scaffolds. Two independent investigators performed the research using MEDLINE, Scopus, Embase and Cochrane Databases (1950 to January 2018). The search terms used were “arthroscopic” OR “arthroscopy” AND “rotator cuff” AND “augmentation” OR “scaffold” OR “patch” OR “matrix” OR “xenograft” OR “allograft” OR “autograft”. A total of 10 articles met our inclusion criteria. Mean age at surgery was 61.92 years and size lesion ranged from small-intermediate lesion (3–6 mm) to irreparable/massive lesion. In 19 (10.67%) cases surgery was performed on recurrent rotator cuff repair with failed previous repair. Mean follow-up was 24.70 months. On 178 shoulders repaired, 32 (17.97%) reported a retear. As regards complications rate a total of 18 (10.11%) were noted. In conclusion, this review shows arthroscopic rotator cuff repair with scaffold can be considered an effective and safe treatment particularly for large or masive rotator cuff lesions, potentially able to provide clinical improvement.
KeywordsRotator cuff Arthroscopy Scaffold Patch Augmentation Graft Autograft Massive lesion Xenograft Autograft
All authors equally contributed to this paper, in terms of the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Compliance with ethical standards
Conflict of interest
Dr. Usuelli reports personal fees from Integra and Geistlich, grants and personal fees from Zimmer, outside the submitted work. Dr. D’Ambrosi, Dr. Ragone, Dr. Comaschi, and Dr. Ursino declares that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
- Arimura H, Shukunami C, Tokunaga T, Karasugi T, Okamoto N, Taniwaki T, Sakamoto H, Mizuta H, Hiraki Y (2017) TGF-β1 improves biomechanical strength by extracellular matrix accumulation without increasing the number of tenogenic lineage cells in a rat rotator cuff repair model. Am J Sports Med 45:2394–2404. https://doi.org/10.1177/0363546517707940 CrossRefGoogle Scholar
- Bokor DJ, Sonnabend D, Deady L, Cass B, Young A, Van Kampen C, Arnoczky S (2016) Evidence of healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a collagen implant: a 2-year MRI follow-up. Muscles Ligaments Tendons J. 6:16–25. https://doi.org/10.11138/mltj/2016.6.1.016 Google Scholar
- Consigliere P, Polyzois I, Sarkhel T, Gupta R, Levy O, Narvani AA (2017) Preliminary results of a consecutive series of large & massive rotator cuff tears treated with arthroscopic rotator cuff repairs augmented with extracellular matrix. Arch Bone Jt Surg. 5:14–21Google Scholar
- Fini M, Bondioli E, Castagna A, Torricelli P, Giavaresi G, Rotini R, Marinelli A, Guerra E, Orlandi C, Carboni A, Aiti A, Benedettini E, Giardino R, Melandri D (2012) Decellularized human dermis to treat massive rotator cuff tears: in vitro evaluations. Connect Tissue Res 53:298–306. https://doi.org/10.3109/03008207.2011.649929 CrossRefGoogle Scholar
- Flury M, Rickenbacher D, Jung C, Schneider MM, Endell D, Audigé L (2018) Porcine dermis patch augmentation of supraspinatus tendon repairs: a pilot study assessing tendon integrity and shoulder function 2 years after arthroscopic repair in patients aged 60 years or older. Arthroscopy 34:24–37. https://doi.org/10.1016/j.arthro.2017.06.024 CrossRefGoogle Scholar
- Gilot GJ, Alvarez-Pinzon AM, Barcksdale L, Westerdahl D, Krill M, Peck E (2015) Outcome of large to massive rotator cuff tears repaired with and without extracellular matrixaugmentation: a prospective comparative study. Arthroscopy 31:1459–1465. https://doi.org/10.1016/j.arthro.2015.02.032 CrossRefGoogle Scholar
- Nossov S, Dines JS, Murrell GA, Rodeo SA (2014) Bedi A (2014) Biologic augmentation of tendon-to-bone healing: scaffolds, mechanical load, vitamin D, and diabetes. Instr Course Lect 63:451–462Google Scholar
- Thangarajah T, Sanghani-Kerai A, Henshaw F, Lambert SM, Pendegrass CJ, Blunn GW (2018) Application of a demineralized cortical bone matrix and bone marrow-derived mesenchymal stem cells in a model of chronic rotator cuff degeneration. Am J Sports Med 46:98–108. https://doi.org/10.1177/0363546517727512 CrossRefGoogle Scholar