scholarly journals Effect of co-administration of atelocollagen and hyaluronic acid on rotator cuff healing

2021 ◽  
Vol 24 (3) ◽  
pp. 147-155
Author(s):  
Jeung Yeol Jeong ◽  
Eun Kyung Khil ◽  
Tae Soung Kim ◽  
Young Woo Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hyaluronic Acid ◽  
Rotator Cuff ◽  
Full Thickness ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Group Iii ◽  
Injection Group ◽  
Group I ◽  
Cuff Repair

Background: This study aimed to evaluate the co-administration effect of atelocollagen combined with hyaluronic acid (HA) injections for treatment of full-thickness rotator cuff tear (RCT).Methods: Eighty patients who underwent arthroscopic rotator cuff repair for full-thickness RCT from March 2018 to November 2019 were enrolled. The patients were randomly allocated to the following groups: combined atelocollagen and HA injection (group I, n=28), only HA injection (group II, n=26), and no injection (group III, n=26). Clinical outcomes were assessed at 3, 6, and 12 months after surgery using the American Shoulder and Elbow Surgeons score, visual analog scale pain, functional scores (pain visual analog scale, function visual analog score), and range of motion. Magnetic resonance imaging was performed 12 months after surgery to evaluate rotator cuff integrity.Results: Preoperative demographic data and postoperative clinical outcomes did not differ significantly among the three groups (p>0.05). However, in group I, the number of steroid injections after surgery was significantly lower than that in the other groups (p=0.011). The retear rate on follow-up magnetic resonance imaging was significantly higher in group II (9.5%, n=2) and group III (13.6%, n=3) than in group I (0%) (p=0.021).Conclusions: Co-administration of atelocollagen and HA improves healing of the rotator cuff and increases the integrity of the rotator cuff repair site. This study provides encouraging evidence for use of combined atelocollagen-HA injections to treat patients with full-thickness RCT.

scholarly journals Advantages of Arthroscopic Rotator Cuff Repair With a Transosseous Suture Technique: A Prospective Randomized Controlled Trial

2017 ◽  
Vol 45 (9) ◽  
pp. 2000-2009 ◽  
Author(s):  
Pietro Randelli ◽  
Carlo Alberto Stoppani ◽  
Carlo Zaolino ◽  
Alessandra Menon ◽  
Filippo Randelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Controlled Trial ◽  
Resonance Imaging ◽  
Randomized Controlled ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Rotator cuff tear is a common finding in patients with painful, poorly functioning shoulders. The surgical management of this disorder has improved greatly and can now be fully arthroscopic. Purpose: To evaluate clinical and radiological results of arthroscopic rotator cuff repair using 2 different techniques: single-row anchor fixation versus transosseous hardware-free suture repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Sixty-nine patients with rotator cuff tears were enrolled: 35 patients were operated with metal anchors and 34 with standardized transosseous repair. The patients were clinically evaluated before surgery, during the 28 days after surgery, and at least 1 year after the operation by the use of validated rating scores (Constant score, QuickDASH, and numerical rating scale [NRS]). Final follow-up was obtained at more than 3 years by a QuickDASH evaluation to detect any difference from the previous follow-up. During the follow-up, rotator cuff integrity was determined through magnetic resonance imaging and was classified according to the 5 Sugaya categories. Results: Patients operated with the transosseous technique had significantly less pain, especially from the 15th postoperative day: In the third week, the mean NRS value for the anchor group was 3.00 while that for transosseous group was 2.46 ( P = .02); in the fourth week, the values were 2.44 and 1.76, respectively ( P < .01). No differences in functional outcome were noted between the 2 groups at the final evaluation. In the evaluation of rotator cuff repair integrity, based on Sugaya magnetic resonance imaging classification, no significant difference was found between the 2 techniques in terms of retear rate ( P = .81). Conclusion: No significant differences were found between the 2 arthroscopic repair techniques in terms of functional and radiological results. However, postoperative pain decreased more quickly after the transosseous procedure, which therefore emerges as a possible improvement in the surgical repair of the rotator cuff. Registration: NCT01815177 ( ClinicalTrials.gov identifier).

Prediction of Rotator Cuff Repair Results by Magnetic Resonance Imaging

1997 ◽  
Vol 344 ◽  
pp. 275???283 ◽  
Author(s):  
Herv?? Thomazeau ◽  
Eric Boukobza ◽  
Nicolas Morcet ◽  
Jacques Chaperon ◽  
Frantz Langlais
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Resonance Imaging ◽  
Cuff Repair

Failure With Continuity in Rotator Cuff Repair “Healing”

2012 ◽  
Vol 41 (1) ◽  
pp. 134-141 ◽  
Author(s):  
Jesse A. McCarron ◽  
Kathleen A. Derwin ◽  
Michael J. Bey ◽  
Joshua M. Polster ◽  
Jean P. Schils ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Common Phenomenon ◽  
Resonance Imaging ◽  
Tendon Defect ◽  
Total Magnitude ◽  
Abduction Strength ◽  
Cuff Repair ◽  
Tendon Retraction

Background: Ten to seventy percent of rotator cuff repairs form a recurrent defect after surgery. The relationship between retraction of the repaired tendon and formation of a recurrent defect is not well defined. Purpose/Hypotheses: To measure the prevalence, timing, and magnitude of tendon retraction after rotator cuff repair and correlate these outcomes with formation of a full-thickness recurrent tendon defect on magnetic resonance imaging, as well as clinical outcomes. We hypothesized that (1) tendon retraction is a common phenomenon, although not always associated with a recurrent defect; (2) formation of a recurrent tendon defect correlates with the timing of tendon retraction; and (3) clinical outcome correlates with the magnitude of tendon retraction at 52 weeks and the formation of a recurrent tendon defect. Study Design: Case series; Level of evidence, 4. Methods: Fourteen patients underwent arthroscopic rotator cuff repair. Tantalum markers placed within the repaired tendons were used to assess tendon retraction by computed tomography scan at 6, 12, 26, and 52 weeks after operation. Magnetic resonance imaging was performed to assess for recurrent tendon defects. Shoulder function was evaluated using the Penn score, visual analog scale (VAS) score for pain, and isometric scapular-plane abduction strength. Results: All rotator cuff repairs retracted away from their position of initial fixation during the first year after surgery (mean [standard deviation], 16.1 [5.3] mm; range, 5.7-23.2 mm), yet only 30% of patients formed a recurrent defect. Patients who formed a recurrent defect tended to have more tendon retraction during the first 6 weeks after surgery (9.7 [6.0] mm) than those who did not form a defect (4.1 [2.2] mm) ( P = .08), but the total magnitude of tendon retraction was not significantly different between patient groups at 52 weeks. There was no significant correlation between the magnitude of tendon retraction and the Penn score ( r = 0.01, P = .97) or normalized scapular abduction strength ( r = −0.21, P = .58). However, patients who formed a recurrent defect tended to have lower Penn scores at 52 weeks ( P = .1). Conclusion: Early tendon retraction, but not the total magnitude, correlates with formation of a recurrent tendon defect and worse clinical outcomes. “Failure with continuity” (tendon retraction without a recurrent defect) appears to be a common phenomenon after rotator cuff repair. These data suggest that repairs should be protected in the early postoperative period and repair strategies should endeavor to mechanically and biologically augment the repair during this critical early period.

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