Arthroscopic “Interval Slide” in the Repair of Large Rotator Cuff Tears

Tauro, Joseph C.

doi:10.1053/ar.1999.v15.0150521

Cited by 89 publications

(36 citation statements)

References 9 publications

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“…17 This phenomenon of decreased muscle compliance is well known to shoulder surgeons as large and massive RCTs often require advanced techniques to advance stiff, noncompliant muscle to reduce the chronic tear back to the greater tuberosity. 20,31 However, even these advanced techniques have shown less than favorable results, possibly owing to the inherent muscle changes after tear (fibrosis, fatty infiltration, stiffness). Kim et al 11 recently reviewed the results of interval slide techniques to advance stiff, retracted RCTs and found that despite improved clinical outcomes, a posterior interval slide to release the rotator cuff resulted in a 91% retear rate at 2-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Upregulation of transforming growth factor-β signaling in a rat model of rotator cuff tears

Liu

Joshi

Ravishankar

et al. 2014

Journal of Shoulder and Elbow Surgery

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Background Muscle atrophy, fatty infiltration, and fibrosis of the muscle have been described as important factors governing outcome after rotator cuff injury and repair. Muscle fibrosis is also thought to have a role in determining muscle compliance at the time of surgery. The transforming growth factor-β (TGF-β) pathways are highly conserved pathways that exert a potent level of control over muscle gene expression and are critical regulators of fibrosis in multiple organ systems. It has been shown that TGF-β can regulate important pathways of muscle atrophy, including the Akt/mammalian target of rapamycin pathway. The purpose of this study was to evaluate the expression of TGF-β and its downstream effectors of fibrosis after a massive rotator cuff tear (RCT) in a previously established rat model. Methods To simulate a massive RCT, infraspinatus and supraspinatus tenotomy and suprascapular nerve transection were performed on Sprague-Dawley rats with use of a validated model. Two and 6 weeks after surgery, supraspinatus muscles were harvested to study alterations in TGF-β signaling by Western blotting, quantitative polymerase chain reaction, and histologic analysis. Results There was a significant increase in fibrosis in the rotator cuff muscle after RCT in our animal model. There was a concomitant increase in TGF-β gene and protein expression at both 2 and 6 weeks after RCT. Evaluation of the TGF-β signaling pathway revealed an increase in SMAD2 activation but not in SMAD3. There was an increase in profibrotic markers collagen I, collagen III, and α-smooth muscle actin. Conclusions TGF-β signaling is significantly upregulated in rat supraspinatus muscles after RCTs.

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Section: Discussionmentioning

confidence: 99%

Upregulation of transforming growth factor-β signaling in a rat model of rotator cuff tears

Liu

Joshi

Ravishankar

et al. 2014

Journal of Shoulder and Elbow Surgery

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“…[13][14][15][16][17] Numerous studies have described different techniques for tendon repair. These include suture techniques, 18 tendon-to-bone fixation, 19 tendon mobilizing and sliding techniques for retracted tears, 20 and use of various tissue or synthetic tendon grafts. [21][22][23] Biological factors for tendon repair may play an important role in the progression of rotator cuff tendon healing.…”

Section: Introductionmentioning

confidence: 99%

Autologous Tenocyte Therapy Using Porcine-Derived Bioscaffolds for Massive Rotator Cuff Defect in Rabbits

Chen

Willers²,

Xu³

et al. 2007

Tissue Engineering

137

113

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Large and retracted rotator cuff tendon tears fail to repair or retear after surgical intervention. This study attempted to develop novel tissue-engineering approaches using tenocyte-seeded bioscaffolds for tendon reconstruction of massive rotator cuff tendon defect in rabbits. Porcine small intestine submucosa (Restore) and type I/III collagen bioscaffold (ACI-Maix) were chosen as bioscaffold carriers for autologous tenocytes. Biological characterization of autologous tenocytes was conducted before the implantation. The tenocyte-seeded bioscaffolds were implanted as interposition grafts to reconstruct massive rotator cuff tendon defects in rabbits. In situ reimplantation of the autologous rotator cuff tendon, excised during defect creation, served as a positive control. Histological outcomes were analyzed and semi-quantitatively graded at 4 and 8 weeks after surgery. At 4 weeks, both tenocyte-seeded bioscaffolds displayed inflammatory reaction similar to bioscaffold-only cuff reconstruction, and the histological grading were inferior to control repair. However, at 8 weeks, inflammatory reaction of both tenocyte-seeded bioscaffolds were dramatically less than with bioscaffold alone. In addition, bioscaffolds seeded with tenocytes generated a histological appearance similar to that of the positive control. The implantation of autologous tenocytes on collagen-based bioscaffolds results in better rotator cuff tendon healing and remodeling than with the implantation of bioscaffold alone.

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“…Several studies have shown reduced strain and tension on the repair with this technique, with corresponding satisfactory clinical outcomes [67][68][69]. The anterior interval slide, described by Tauro in 1999, is a technique to improve mobility of a retracted, supraspinatus tendon by releasing the coracohumeral ligament and rotator interval tissue [70]. Lo et al expanded on this concept and described a posterior interval slide in which the plane of tissue between the supraspinatus and infraspinatus is released along the scapular spine in tears that require increased mobility after anterior interval release [71].…”

Section: Margin Convergence and Interval Slidesmentioning

confidence: 99%

Partial and Full-Thickness RCT: Modern Repair Techniques

Nathani

Smith

Wang

2018

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this article is to review the recent literature concerning modern repair techniques related to partial-and full-thickness rotator cuff tears. Recent Findings The understanding of rotator cuff pathology and healing continues to evolve, beginning with emerging descriptions of the anatomic footprint and natural history of rotator cuff tears. Significant controversy remains in treatment indications for partial-thickness rotator cuff lesions as well as optimal surgical repair techniques for both partial-and full-thickness tears. Techniques such as margin convergence and reduction of the so-called "comma" tissue have improved the ability to anatomically reduce large and retracted tears. Repair strength and contact pressures are improved with double-row repairs and transosseusequivalent techniques compared to traditional single-row repairs. Future work is directed towards obtaining reliable radiographic healing and demonstrating clinical superiority and cost-effectiveness of a single technique. Summary Much recent work regarding rotator cuff anatomy and pathology has been reported. Newer techniques improve repair strength. Despite these advances, significant questions remain concerning surgical indications and clinical outcomes.

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Arthroscopic “Interval Slide” in the Repair of Large Rotator Cuff Tears

Cited by 89 publications

References 9 publications

Upregulation of transforming growth factor-β signaling in a rat model of rotator cuff tears

Upregulation of transforming growth factor-β signaling in a rat model of rotator cuff tears

Autologous Tenocyte Therapy Using Porcine-Derived Bioscaffolds for Massive Rotator Cuff Defect in Rabbits

Partial and Full-Thickness RCT: Modern Repair Techniques

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