Current Trends in Rotator Cuff Repair: Surgical Technique, Setting, and Cost

Iyengar, Jaicharan J.; Samagh, Sanjum P.; Schairer, William W.; Singh, Gaurav; Valone, Frank H.; Feeley, Brian T.

doi:10.1016/j.arthro.2013.11.018

Cited by 104 publications

(69 citation statements)

References 13 publications

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“…In contrast to the natural attachment, contemporary surgical procedures introduce smooth and regular interfaces at the reattachment of tendon to bone, often by debridement and smoothing of the bony surface (39). This approach may not lead to an effectively repaired interface.…”

Section: Discussionmentioning

confidence: 95%

Stochastic Interdigitation as a Toughening Mechanism at the Interface between Tendon and Bone

Birman²,

Deymier-Black

et al. 2015

Biophysical Journal

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Reattachment and healing of tendon to bone poses a persistent clinical challenge and often results in poor outcomes, in part because the mechanisms that imbue the uninjured tendon-to-bone attachment with toughness are not known. One feature of typical tendon-to-bone surgical repairs is direct attachment of tendon to smooth bone. The native tendon-to-bone attachment, however, presents a rough mineralized interface that might serve an important role in stress transfer between tendon and bone. In this study, we examined the effects of interfacial roughness and interdigital stochasticity on the strength and toughness of a bimaterial interface. Closed form linear approximations of the amplification of stresses at the rough interface were derived and applied in a two-dimensional unit-cell model. Results demonstrated that roughness may serve to increase the toughness of the tendon-to-bone insertion site at the expense of its strength. Results further suggested that the natural tendon-to-bone attachment presents roughness for which the gain in toughness outweighs the loss in strength. More generally, our results suggest a pathway for stochasticity to improve surgical reattachment strategies and structural engineering attachments.

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Section: Discussionmentioning

confidence: 95%

Stochastic Interdigitation as a Toughening Mechanism at the Interface between Tendon and Bone

Birman²,

Deymier-Black

et al. 2015

Biophysical Journal

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“…Rotator cuff (RC) reconstruction is currently the gold standard for the treatment of RCT. It has been estimated that over 270,000 RC reconstructions are performed in the United States each year, and the rate is continuing to increase [4,5,6]. Patients with an intact RC after reconstructive surgery tend to have notably improved functional outcomes [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Zhang

Wang

et al. 2016

IJMS

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To investigate whether the systematic administration of icariin (ICA) promotes tendon-bone healing after rotator cuff reconstruction in vivo, a total of 64 male Sprague Dawley rats were used in a rotator cuff injury model and underwent rotator cuff reconstruction (bone tunnel suture fixation). Rats from the ICA group (n = 32) were gavage-fed daily with ICA at 0.125 mg/g, while rats in the control group (n = 32) received saline only. Micro-computed tomography, biomechanical tests, serum ELISA (calcium; Ca, alkaline phosphatase; AP, osteocalcin; OCN) and histological examinations (Safranin O and Fast Green staining, type I, II and III collagen (Col1, Col2, and Col3), CD31, and vascular endothelial growth factor (VEGF)) were analyzed two and four weeks after surgery. In the ICA group, the serum levels of AP and OCN were higher than in the control group. More Col1-, Col2-, CD31-, and VEGF-positive cells, together with a greater degree of osteogenesis, were detected in the ICA group compared with the control group. During mechanical testing, the ICA group showed a significantly higher ultimate failure load than the control group at both two and four weeks. Our results indicate that the systematic administration of ICA could promote angiogenesis and tendon-bone healing after rotator cuff reconstruction, with superior mechanical strength compared with the controls. Treatment for rotator cuff injury using systematically-administered ICA could be a promising strategy.

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“…Sie ist in der Regel technisch schwieriger, erfordert eine längere Operationszeit und erhöht signifikant die Implantatkosten im Vergleich zu einer Einreihenrekonstruktion [1,9,42]. Insbesondere unter dem Aspekt des dramatischen Anstiegs der arthroskopischen Versorgungen von Rotatorenmanschettenrupturen, mit denen auch ein signifikanter Anstieg der Krankenhaushonorare und -kosten verbunden ist, gewinnt der finanzielle Aspekt zunehmend an Bedeutung [20]. Daher ist es notwendig, den möglichen Vorteil in der Patientenversorgung mit Hilfe einer neuen Technikinnovation auch unter dem finanziellen Aspekt zu hinterfragen.…”

Section: Doppelreihenrekonstruktion Der Rotatorenmanschetteunclassified

Aktuelle Nahttechniken zur Rekonstruktion der Rotatorenmanschette

Lorbach

Haupert

2015

Obere Extremität

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Die Ergebnisse der arthroskopischen und offenen Rekonstruktion von Rupturen der Rotatorenmanschette zeigen gute bis exzellente klinische Ergebnisse [10,19,44]. Insbesondere bei großen chronischen Defekten kommt es jedoch in einer hohen Anzahl der Fälle zum Versagen der Rekonstruktion und damit zur Reruptur der Rotatorenmanschette [11,18]. Aus biomechanischer Sicht liegt daher das Hauptinteresse an der Entwicklung von Nahttechniken, welche idealerweise eine möglichst stabile Fixierung der Sehne am Knochen ermöglichen mit einer hohen Versagenslast auf der einen Seite und einer minimalen Elongation unter zyklischer Belastung auf der anderen Seite [14].

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Current Trends in Rotator Cuff Repair: Surgical Technique, Setting, and Cost

Cited by 104 publications

References 13 publications

Stochastic Interdigitation as a Toughening Mechanism at the Interface between Tendon and Bone

Stochastic Interdigitation as a Toughening Mechanism at the Interface between Tendon and Bone

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Aktuelle Nahttechniken zur Rekonstruktion der Rotatorenmanschette

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