Extracellular matrix scaffold devices for rotator cuff repair

Derwin, Kathleen A.; Badylak, Stephen F.; Steinmann, Scott P.; Iannotti, Joseph P.

doi:10.1016/j.jse.2009.10.020

Cited by 178 publications

(148 citation statements)

References 81 publications

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“…8 Newer tissue processing and sterilization techniques, however, have mitigated these drawbacks and have shown minimal complications in animal and human studies. 1,9,10 Overall, surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Patch augmentation using the technique described in this article is an option in the treatment of massive cuff tears.…”

Section: Discussionmentioning

confidence: 99%

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All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique

Chalmers

Frank

Gupta

et al. 2013

Arthroscopy Techniques

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Surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Multiple different arthroscopic and open techniques have been described, but there is no current gold standard. Failure after rotator cuff repair is typically multifactorial; however, failure of tendon-footprint healing is often implicated. Patch augmentation has been described as a possible technique to augment the biology of rotator cuff repair in situations of compromised tendon quality and has shown promising short-term results. The purpose of this article is to describe our preferred surgical technique for arthroscopic rotator cuff repair with patch augmentation.

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Section: Discussionmentioning

confidence: 99%

“…1,2 Multiple surgical techniques have been described; there is no current gold standard. Treatment options include debridement with possible biceps tenotomy/tenodesis, partial repair, muscle transfer, tissue interposition, and repair with patch augmentation.…”

mentioning

confidence: 99%

All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique

Chalmers

Frank

Gupta

et al. 2013

Arthroscopy Techniques

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“…Currently, scaffolds derived from various natural and synthetic biomaterials are being marketed as augmentation devices for rotator cuff repairs at the time of 3,9,10 surgery.…”

Section: Synovial Fluidmentioning

confidence: 99%

The biomechanical role of scaffolds in augmented rotator cuff tendon repairs

Aurora¹,

McCarron²,

Bogert³

et al. 2012

Journal of Shoulder and Elbow Surgery

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“…2,3 Tears of the rotator cuff tendon in the shoulder are a particular problem, with full-thickness tearstissue-engineered biomaterial aims to promote full tendon regeneration and recovery by providing temporary mechanical support to the injured tendon, and enhancing tendon cell growth and activity. 12,[17][18][19][20] There are a number of Food and Drug Administration (FDA)-approved biomaterial scaffolds available for use in rotator cuff repair, 21 and while some of these scaffolds appear to improve clinical outcomes, the results are generally inconclusive due to the lack of appropriate controls. [22][23][24] This leads to the consensus view that currently available scaffolds, while promising, fail to meet clinical needs.…”

Section: Introductionmentioning

confidence: 99%

In VitroEvaluation of a Novel Non-Mulberry Silk Scaffold for Use in Tendon Regeneration

Musson

Naot

Chhana

et al. 2015

Tissue Engineering Part A

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Tearing of the rotator cuff tendon in the shoulder is a significant clinical problem, with large/full-thickness tears present in *22% of the general population and recurrent tear rates postarthroscopic repair being quoted as high as 94%. Tissue-engineered biomaterials are increasingly being investigated as a means to augment rotator cuff repairs, with the aim of inducing host cell responses to increase tendon tissue regeneration. Silk-derived materials are of particular interest due to the high availability, mechanical strength, and biocompatibility of silks. In this study, Spidrex Ò , a novel knitted, non-mulberry silk fibroin scaffold was evaluated in vitro for its potential to improve tendon regeneration. Spidrex was compared with a knitted Bombyx mori silk scaffold, a 3D collagen gel and Fiberwire Ò suture material. Primary human and rat tenocytes successfully adhered to Spidrex and significantly increased in number over a 14 day period ( p < 0.05), as demonstrated by fluorescent calcein-AM staining and alamarBlue Ò assays. A similar growth pattern was observed with human tenocytes cultured on the B. mori scaffold. Morphologically, human tenocytes elongated along the silk fibers of Spidrex, assuming a tenocytic cell shape, and were less circular with a higher aspect ratio compared with human tenocytes cultured on the B. mori silk scaffold and within the collagen gel ( p < 0.05). Gene expression analysis by real-time PCR showed that rat tenocytes cultured on Spidrex had increased expression of tenocyte-related genes such as fibromodullin, scleraxis, and tenomodulin ( p < 0.05). Expression of genes that indicate transdifferentiation toward a chondrocytic or osteoblastic lineage were significantly lower in tenocytes cultured on Spidrex in comparison to the collagen gel ( p < 0.05). Immunogenicity assessment by the maturation of and cytokine release from primary human dendritic cells demonstrated that Spidrex enhanced dendritic cell maturation in a similar manner to the clinically used suture material Fiberwire, and significantly upregulated the release of proinflammatory cytokines ( p < 0.05). This suggests that Spidrex may induce an early immune response postimplantation. While further work is required to determine what effect this immune response has on the tendon healing process, our in vitro data suggests that Spidrex may have the cytocompatibility and bioactivity required to support tendon regeneration in vivo.

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Extracellular matrix scaffold devices for rotator cuff repair

Cited by 178 publications

References 81 publications

All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique

All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique

The biomechanical role of scaffolds in augmented rotator cuff tendon repairs

In VitroEvaluation of a Novel Non-Mulberry Silk Scaffold for Use in Tendon Regeneration

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