Evaluation of Radiographic Changes 5 Years After Arthroscopic Rotator Cuff Repair

Background: Rotator cuff repair augmentation using biological materials has become popular in clinical practice to reduce the high retear rates associated with traditional repair techniques. Tissue engineering approaches, such as engineered tendon-fibrocartilage-bone composite (TFBC), have shown promise in enhancing the biological healing of rotator cuff tears in animals. However, previous studies have provided limited long-term data on TFBC repair outcomes. The effect of mechanical stimulation on TFBC has not been explored extensively. Purpose: To evaluate functional outcomes after rotator cuff repair with engineered TFBC subjected to mechanical stimulation in a 6-month follow-up using a canine in vivo model. Study Design: Controlled laboratory study. Methods: A total of 40 canines with an acute infraspinatus (ISP) tendon transection model were randomly allocated to 4 groups (n =10): (1) unilateral ISP tendon undergoing suture repair only (control surgery); (2) augmentation with engineered TFBC alone (TFBC); (3) augmentation with engineered TFBC and bone marrow-derived stem cells (BMSCs) (TFBC+C); and (4) augmentation with engineered TFBC and BMSCs, as well as mechanical stimulation (TFBC+C+M). Outcome measures—including biomechanical evaluations such as failure strength, stiffness, failure mode, gross appearance, ISP tendon and muscle morphological assessment, and histological analysis—were performed 6 months after surgery. Results: As shown in the mechanical test, the TFBC+C+M group exhibited higher failure strength compared with other repair techniques. The most common failure mode was avulsion fracture in the TFBC+C+M group, but tendon-bone junction rupture was observed predominantly in different groups. Engineered TFBC with mechanical stimulation showed over 70% relative failure strength compared with normal ISP, and the other groups showed about 50% relative failure strength. Histological analysis revealed less fat infiltration and closer-to-normal muscle fiber structure in the mechanical stimulation group. Conclusion: This study provides evidence that mechanical stimulation of engineered TFBC promotes rotator cuff regeneration, thus supporting its potential for rotator cuff repair augmentation. Clinical Relevance: This study provides valuable evidence supporting the use of a novel tissue-engineered material (TFBC) in rotator cuff repair and paves the way for advancements in the field of rotator cuff regeneration.

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Rotator cuff tears and mid-term shoulder outcomes after intramedullary nail fixation for humeral shaft fracture: a minimum 5-year follow-up study

Furuhata

Tanji

Nakamura

et al. 2023

Preprint

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Background Antegrade intramedullary nail fixation for humeral shaft fractures yields satisfactory union rates. However, one concern is damage to the rotator cuff during nail insertion, which may affect long-term outcomes. The effect of rotator cuff lesion on mid- and long-term shoulder outcomes remains unknown. This study aimed to investigate the incidence of rotator cuff tears 5 years or more after intramedullary nailing for humeral shaft fractures, and to determine the impact of postoperative rotator cuff tears on mid-term outcomes. Methods We retrospectively identified 22 patients who underwent antegrade intramedullary nail fixation for traumatic humeral shaft fractures and received follow-up for at least 5 years postoperatively. We divided the patients into those without tears and those with partial or complete tears, diagnosed using ultrasonography. We compared the functional and radiological shoulder outcomes between the two groups. Results Of 22 patients, nine had partial or complete supraspinatus tears at a mean follow-up of 7.5 years postoperatively. The incidence of acromial spurs was significantly higher in patients with partial or complete tears than in those without tears (P = 0.002). There were no significant differences in age and gender-adjusted Constant score, and American Shoulder and Elbow Surgeon score between the two groups. Conclusions Our results showed that 41% of patients developed partial or complete supraspinatus tendon tears in the mid-term. Postoperative rotator cuff tears were significantly associated with the formation of acromial spurs; however, it had no significant effect on shoulder functional outcomes.

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Evaluation of Radiographic Changes 5 Years After Arthroscopic Rotator Cuff Repair

Cited by 3 publications

References 57 publications

Anterior glenoid rim resorption after arthroscopic Bankart repair by the footprint fixation technique and its correlation with the healing of the repaired capsulolabral complex: a computed tomography and magnetic resonance arthrography imaging study

Anterior glenoid rim resorption after arthroscopic Bankart repair by the footprint fixation technique and its correlation with the healing of the repaired capsulolabral complex: a computed tomography and magnetic resonance arthrography imaging study

Engineered Tendon-Fibrocartilage-Bone Composite With Mechanical Stimulation for Augmentation of Rotator Cuff Repair: A Study Using an In Vivo Canine Model With a 6-Month Follow-up

Rotator cuff tears and mid-term shoulder outcomes after intramedullary nail fixation for humeral shaft fracture: a minimum 5-year follow-up study

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