Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Derwin, Kathleen A.; Codsi, Michael J.; Milks, Ryan A.; Baker, Andrew R.; McCarron, Jesse A.; Iannotti, Joseph P.
May 2009
Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1159
Academic Journal
Background: Despite advances in surgical treatment options, failure rates of rotator cuff repair have continued to range from 20% to 90%. Hence, there is a need for new repair strategies that provide effective mechanical reinforcement of rotator cuff repair as well as stimulate and enhance the intrinsic healing potential of the patient. The purpose of this study was to evaluate the extent to which augmentation of acute repair of rotator cuff tendons with a newly designed poly-L-lactide repair device would improve functional and biomechanical outcomes in a canine model. Methods: Eight adult, male mongrel dogs (25 to 30 kg) underwent bilateral shoulder surgery. One shoulder underwent tendon release and repair only, and the other was subjected to release and repair followed by augmentation with the repair device. At twelve weeks, tendon retraction, cross-sectional area, stiffness, and ultimate load of the repair site were measured. Augmented repairs underwent histologic assessment of biocompatibility. In addition, eight pairs of canine cadaver shoulders underwent infraspinatus injury and repair with and without device augmentation with use of identical surgical procedures and served as time-zero biomechanical controls. Eight unpaired, canine cadaver shoulders were included as normal biomechanical controls. Results: At time zero, repair augmentation significantly increased the ultimate load (23%) (p = 0.034) but not the stiffness of the canine infraspinatus tendon repair. At twelve weeks, the poly-L-lactide scaffold was observed to be histologically biocompatible, and augmented repairs demonstrated significantly less tendon retraction (p = 0.008) and significantly greater cross-sectional area (137%), stiffness (26%), and ultimate load (35%) than did repairs that had not been augmented (p < 0.001, p = 0.002, and p = 0.009, respectively). Conclusions: While limiting but not eliminating tendon repair retraction, the augmentation device provided a tendon-bone bridge and scaffold for host tissue deposition and ingrowth, resulting in improved biomechanical function of the repair at twelve weeks. Clinical Relevance: The augmentation device, applied in a similar manner as described in the present study, might offer a functional benefit to patients undergoing rotator cuff repair.


Related Articles

  • The DUROM Cup Humeral Surface Replacement in Patients with Rheumatoid Arthritis. Fuerst, Martin; Fink, Bernd; Rüther, Wolfgang // Journal of Bone & Joint Surgery, American Volume;Oct2008 Supplement 2, Vol. 90-A, p287 

    BACKGROUND: Rheumatoid arthritis often leads to severe destruction of the glenohumeral joint, including synovitis and inflammation-induced alterations of the rotator cuff. Cup arthroplasty, or surface replacement of the shoulder, was introduced in the 1980s. The aim of this study was to evaluate...

  • 양측성 회전근 ê°œ 파열에 대한 수술적 치료 ê²°ì • 및 ê²°ê³¼. 장호진; 최창혁; 엄윤식 // Journal of the Korean Orthopaedic Association;Jun2013, Vol. 48 Issue 3, p213 

    Purpose: We evaluated the influencing factors in selection of initial operation and outcomes after operative treatment of symptomatic rotator cuff tear including both sides. Materials and Methods: From December 2000 to March 2011, 60 shoulders of 30 patients underwent arthroscopic rotator cuff...

  • BIPLANE X-RAY ANALYSIS OF IN-VIVO SHOULDER AND TENDON FUNCTION. Bey, M.; Ciarelli, K.; Kolowich, P.; Lock, T.; Moutzouros, V.; Baker, A.; Iannotti, J.; Derwin, K. // Conference Proceedings of the Annual Meeting of the American Soc;2010, p17 

    The article discusses complementary studies on the glenohumeral joint motion after rotator cuff repair in human patients and in-vivo tendon function in a canine model of tendon injury and repair. In the human study, the researchers found that the superior-inferior contact center was different...

  • Enhancement of Periprosthetic Bone Quality with Topical Hydroxyapatite-Bisphosphonate Composite. Suratwala, Sanjeev J.; Cho, Samuel K.; van Raalte, Jonathan J.; Sang Hyun Park; Sung Wook Seo; Seong-Sil Chang; Gardner, Thomas R.; Francis Young-In Lee // Journal of Bone & Joint Surgery, American Volume;Oct2008, Vol. 90-A Issue 10, p2189 

    Background: Implant loosening is associated with inflammatory bone loss induced by ultra-high molecular weight polyethylene wear debris. We hypothesized that a hydroxyapatite-bisphosphonate composite improves periprosthetic bone quality and osseous integration of an intramedullary implant even...

  • Wear Rate of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty: A Randomized Controlled Trial. McCalden, Richard W.; MacDonald, Steven J.; Rorabeck, Cecil H.; Bourne, Robert B.; Chess, David G.; Charron, Kory D. // Journal of Bone & Joint Surgery, American Volume;Apr2009, Vol. 91-A Issue 4, p773 

    Background: Highly cross-linked polyethylene was introduced for clinical use in total hip arthroplasty with the expectation that it would exhibit less wear when compared with conventional polyethylene. The purpose of this study was to report the clinical and radiographic results, after a minimum...

  • Does continuous passive motion help? Rubin, Aaron // Physician & Sportsmedicine;Sep96, Vol. 24 Issue 9, p16o 

    Advises readers on using continuous passive motion (CPM) in patients with rotator cuff repair, as published in `Early results of continuous passive motion after rotator cuff repair: A prospective, randomized, blinded, controlled study,' by M.G. Raab, D. Rzeszutko et al.

  • Surgery for the rotator cuff. R.M.D. // Cortlandt Forum;9/25/96, Vol. 9 Issue 9, p115 

    Offers advice on how to determine if surgery is needed in case of a rotator cuff injury. Clinical examinations of the shoulder.

  • Retrospective Analysis of Titanium Plate-Retained Prostheses Placed After Total Rhinectomy. Sandner, Annett; Bloching, Marc // International Journal of Oral & Maxillofacial Implants;2009, Vol. 24 Issue 1, p118 

    Purpose: To report the use of a new platelike system (Titanium Epiplating System, Medicon, Tuttlingen, Germany) for rehabilitation of patients after total rhinectomy. Materials and Methods: This retrospective study was conducted on all patients treated between August 2001 and July 2006 with...

  • Reply to the Letter to the Editor: Advantages of Arthroscopic Transosseous Suture Repair of the Rotator Cuff without the Use of Anchors. Kuroda, Shigehito; Ishige, Noriyuki; Mikasa, Motohiko // Clinical Orthopaedics & Related Research;Mar2014, Vol. 472 Issue 3, p1044 

    A response from the author of the article "Advantages of Arthroscopic Transosseous Suture Repair of the Rotator Cuff Without the Use of Anchors" that was published in the previous issue is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics