Clinical perspectives for repairing rotator cuff injuries with multi-tissue regenerative approaches

Zhang, Xu; Wang, Dan; Wang, Zuyong; Ling, Samuel Ka-Kin; Yung, Patrick Shu‐Hang; Tuan, Rocky S.; Ker, Dai Fei Elmer

doi:10.1016/j.jot.2022.06.004

Cited by 13 publications

(14 citation statements)

References 196 publications

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“…It has been well-established that patients who reside in low socioeconomic areas face barriers in receiving postoperative care after their rotator cuff surgery, particularly physical therapy. 6,9,38 Although our study did not assess differences in postoperative physical therapy compliance and attendance between the ADI groups, such differences could be a major factor affecting the final shoulder ROM. Therefore, further research is required to understand the effect on the ADI for accessing physical therapy and rehabilitation after orthopaedic shoulder surgery.…”

Section: Discussionmentioning

confidence: 96%

Use of Area Deprivation Index to Predict Minimal Clinically Important Difference for Patient Reported Outcomes Measurement Information System After Arthroscopic Rotator Cuff Repair

et al. 2023

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Background: Socioeconomic disparities correlate with worse outcomes after arthroscopic rotator cuff repair. However, use of a surrogate to describe socioeconomic disadvantage has been a challenge. The Area Deprivation Index (ADI) is a tool that encompasses 17 socioeconomic variables into a single metric based on census location. Hypothesis: Higher ADI would result in a worse minimal clinically important difference (MCID) for the Patient Reported Outcomes Measurement Information System (PROMIS) and have less improvement in range of motion (ROM) following arthroscopic rotator cuff repair (ARCR). Study Design: Cohort study; Level of evidence, 3. Method: A retrospective review was performed for patients who underwent arthroscopic rotator cuff repair. Patients in the most socioeconomically disadvantaged quartile (ADIHigh) were compared with the least disadvantaged quartile (ADILow) in the ability to reach MCID. Demographic and surgical features were assessed for attainment of MCID. Results: In total 1382 patients were identified who underwent ARCR, of which a total of 306 patients met final inclusion criteria. A higher percentage of patients within the ADIHigh cohort identified as “Black” or “other” race and had government-issued insurance compared with the ADILow cohort ( P < .05). The ADIHigh cohort had significantly worse postoperative forward flexion compared with the ADILow cohort (145.0°± 32.5° vs 156.3°± 23.4°; P = .001) despite starting with comparable preoperative ROM ( P = .17). Logistic regression showed that ADI was the only variable significant for predicting achievement of MCID for all 3 PROMIS domains, with the ADIHigh cohort having significantly worse odds of achieving MCID Physical Function (odds ratio [OR], 0.31; P = .001), Pain Interference (OR, 0.21; P = .001), and Depression (OR, 0.28; P = .001). Meanwhile, age, sex, body mass index, and smoking history were nonsignificant. Moreover, “other” for race and Medicare insurance were significant for achievement of MCID Depression but not Physical Function or Pain Interference. Finally, ADI was the main feature for predictive logistic regression modeling. Conclusion: ADI served as the only significant predictor for achieving MCID for all 3 PROMIS domains after arthroscopic rotator cuff repair. Patients who face high levels of socioeconomic disadvantage have lower rates of achieving MCID. In addition, patients with greater neighborhood disadvantage demonstrated significantly worse improvement in active forward flexion. Further investigation is required to understand the role of ADI on physical therapy compliance and to identify the barriers that prevent equitable postoperative care.

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Section: Discussionmentioning

confidence: 96%

Use of Area Deprivation Index to Predict Minimal Clinically Important Difference for Patient Reported Outcomes Measurement Information System After Arthroscopic Rotator Cuff Repair

et al. 2023

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“…13 In addition, there has been increased recognition that a highly regenerative environment is necessary to ensure complete rotator cuff tissue healing and the recovery of shoulder function. 4 In this narrative review, we will evaluate the effective use and efficacy of the principle regenerative treatments such as PRP, stem cells, prolotherapy, and so on.…”

Section: Regenerative Medicinementioning

confidence: 99%

“…52 Exosomes have been demonstrated to have regenerative effects on the muscles in massive or chronic rotator cuff tears in order to prevent tendon atrophy, fatty degeneration, inflammation, and vascularization. 4 CONCLUSION RC injuries can be debilitating for athletes and can lead them to withdraw from sporting activity even for several months, causing pain, functional impotence, and the risk of recurrence. Regenerative medicine offers a range of possibilities for the treatment of these pathologies.…”

Section: Other Regenerative Medicine Optionsmentioning

confidence: 99%

“…In addition, other muscles and tendons assist the RC structure, strengthening shoulder movements. Acute trauma and overuse increase the risk of injury to the shoulder 4 …”

Section: Rc Anatomymentioning

confidence: 99%

“…Although there have been numerous advances and developments in existing clinical techniques and commercially available biomaterials, long-term functional recovery for severely injured rotator cuff tissues remains challenging 13 . In addition, there has been increased recognition that a highly regenerative environment is necessary to ensure complete rotator cuff tissue healing and the recovery of shoulder function 4 . In this narrative review, we will evaluate the effective use and efficacy of the principle regenerative treatments such as PRP, stem cells, prolotherapy, and so on.…”

Section: Regenerative Medicinementioning

confidence: 99%

See 2 more Smart Citations

Regenerative Medicine Solutions for Rotator Cuff Injuries in Athletes: Indications and Outcomes

Foti,

Vellucci,

Santoro

2024

Sports Medicine and Arthroscopy Review

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Rotator cuff (RC) injuries include a wide range of pathologic states. Athletes are perhaps the most susceptible to RC injuries ranging from tendinopathy to partial or full-thickness tears, due to functional overload and repetitive movements, causing abstention from sports for long periods. Regenerative medicine keeps giving us multiple choices to fight the disability caused by these pathologies. A literature search was performed, and findings related to the structure-function of rotator cuff units, pathophysiology of injuries, regenerative medicine treatments, and future strategies were outlined. Platelet-rich plasma (PRP) has a greater number of articles and clinical trials, accompanied by stem cells progenitor, prolotherapy, and new approaches such as microfragmented adipose tissue and exosomes. RC injuries in athletes can cause pain, functional impotence, and the risk of recurrence, and can lead them to stop playing sports. Regenerative medicine offers a range of treatments, but some of them need further studies to underline their actual validity.

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Organoids of Musculoskeletal System for Disease Modeling, Drug Screening, and Regeneration

Chen,

Liu,

et al. 2024

Adv Healthcare Materials

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Musculoskeletal diseases have emerged as the leading cause of disability worldwide, with their prevalence increasing annually. In light of this escalating health challenge, organoids, an emerging technology in tissue engineering, offer promising solutions for disease modeling, drug screening, regeneration, and repair processes. The successful development of musculoskeletal organoids represents a significant breakthrough, providing a novel platform for studying musculoskeletal diseases and facilitating the discovery of new treatments. Moreover, organoids serve as valuable complements to traditional 2D culture methods and animal models, offering rich insights into musculoskeletal biology. This review provides an overview of organoid technology, outlining the construction processes of various musculoskeletal organoids and highlighting their similarities and differences. Furthermore, the challenges associated with organoid technology in musculoskeletal systems are discussed and insights into future perspectives are offered.

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Clinical perspectives for repairing rotator cuff injuries with multi-tissue regenerative approaches

Cited by 13 publications

References 196 publications

Use of Area Deprivation Index to Predict Minimal Clinically Important Difference for Patient Reported Outcomes Measurement Information System After Arthroscopic Rotator Cuff Repair

Use of Area Deprivation Index to Predict Minimal Clinically Important Difference for Patient Reported Outcomes Measurement Information System After Arthroscopic Rotator Cuff Repair

Regenerative Medicine Solutions for Rotator Cuff Injuries in Athletes: Indications and Outcomes

Organoids of Musculoskeletal System for Disease Modeling, Drug Screening, and Regeneration

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