Background: Since the establishment of biological augmentation to improve the treatment of rotator cuff tears, it is imperative to explore newer techniques to reduce the retear rate and improve long-term shoulder function after rotator cuff repair. This study was undertaken to determine the consequences of a gel-type atelocollagen injection during arthroscopic rotator cuff repair on clinical outcomes, and evaluate its effect on structural integrity.Methods: Between January 2014 and June 2015, 121 patients with full thickness rotator cuff tears underwent arthroscopic rotator cuff repair. Of these, 61 patients were subjected to arthroscopic rotator cuff repair in combination with an atelocollagen injection (group I), and 60 patients underwent arthroscopic rotator cuff repair alone (group II). The visual analogue scale (VAS) for pain and the Korean Shoulder Society (KSS) scores were evaluated preoperatively and postoperatively. Magnetic resonance imaging (MRI) was performed at 6 months postoperatively, to assess the integrity of the repair.Results: VAS scores were significantly lower in group I than in group II at 3, 7, and 14 days after surgery. KSS scores showed no significant difference between groups in the 24 months period of follow-up. No significant difference was obtained in the healing rate of the rotator cuff tear at 6 months postoperatively (<i>p</i>=0.529).Conclusions: Although a gel-type atelocollagen injection results in reduced pain in patients at 2 weeks after surgery, our study does not substantiate the administration of atelocollagen during rotator cuff repair to improve the clinical outcomes and healing of the rotator cuff.

PURPOSE: Our purpose was to assess the short-term results of arthroscopic bridging repair of massive, irreparable rotator cuff tears by use of a Permacol(R).MATERIALS AND METHODS: Between October 2010 and April 2011, 6 patients with massive, irreparable rotator cuff tears were treated with arthroscopic bridging repair using a Permacol(R). All were evaluated preoperatively and postoperatively by use of the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging was performed postoperatively at mean 4.2 months (range, 2 to 10 months) after operation.RESULTS: At a mean follow-up of 7 months (range, 4 to 12 months), the mean KSS increased significantly from preoperatively mean 53.0 to postoperatively mean 72.3 (p=0.046). Statistically insignificant improvements were seen in pain (p=0.066) and range of motion (p=0.336). As documented on magnetic resonance imaging, there were two patients with full incorporation of the graft into the native tissue, 1 partial retear, and 3 complete retear. There were no complications such as adverse inflammatory or septic joint in these patients.CONCLUSION: Although Permacol(R), porcine dermal xenograft may be effective in other areas of the body for tendon healing, its use in bridging repair of massive, irreparable rotator cuff tears seems to have to be chosen prudently and warrants further evaluation.

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Background: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. Methods: Total of 81 male patients (mean age 57.8 ± 7.4 years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system PRO ® (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age 56.9 ± 7.3 years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane.Results: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. Conclusions: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.(Clin Shoulder Elbow 2014;17(4):166-174)

Background: Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms.