Healing rate and clinical outcomes of xenografts appear to be inferior when compared to other graft material in rotator cuff repair: a meta-analysis

Y, Ono; Herrera, Diego Alejandro Dávalos; Woodmass, Jarret M.; Boorman, Richard S.; Thornton, Gail M.; Lo, Ian K.Y.

doi:10.1136/jisakos-2016-000076

Cited by 10 publications

(10 citation statements)

References 52 publications

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“…In Germany, for example, allograft materials are subjected to regulations based on transplantation law. In Japan the use of allografts is not approved in general [ 22 ]. An additional advantage, besides the ease of availability of bovine collagen, is that it can also be used in patients who reject porcine products for religious reasons.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical, Biochemical, and Cell Biological Evaluation of Different Collagen Scaffolds for Tendon Augmentation

Gabler

Spohn

Tischer

et al. 2018

BioMed Research International

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Tendon augmentation is increasingly clinically relevant due to rising amount of tendon ruptures because of the aging and more demanding population. Therefore, newly developed scaffolds based on bovine epoxide stabilized collagen maintaining the native fibril-like collagen structure were characterized and compared to two commercially available porcine collagen scaffolds. For biomechanical testing (ultimate load, ultimate stress, stiffness, and elastic modulus), bovine collagen scaffolds were hydrated and compared to reference products. Cell viability and proliferation were assessed by seeding human primary fibroblasts on each collagen-based scaffold and cultured over various time periods (3 d, 7 d, and 14 d). Live/dead staining was performed and metabolic cell activity (WST-1 assay) was measured. Biochemical degradability was investigated by enzymatic digestion. The bovine collagen scaffold showed significantly enhanced biomechanical properties. These persisted over different rehydration times. Cell biological tests revealed that the bovine collagen scaffolds support reproducible cell colonization and a significant increase in the number of viable cells during cultivation. The results are comparable with the viability and proliferation rate of cells grown on porcine reference materials. With regard to biochemical degradability, all tested materials showed comparable resistance to enzymatic degradation in vitro. Due to imitating the natural tendon structure the new scaffold material is supposed to provide beneficial effects in future clinical application.

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Section: Discussionmentioning

confidence: 99%

Biomechanical, Biochemical, and Cell Biological Evaluation of Different Collagen Scaffolds for Tendon Augmentation

Gabler

Spohn

Tischer

et al. 2018

BioMed Research International

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show abstract

“…These criteria were based on previous studies using MRI and ultrasonography (Figure 5). 15,23,24,37,38,42,43 The diagnosis of a retear was made by 1 treating and 2 nontreating orthopaedic surgeons. In cases in which there was a discrepancy between the assessments, the poorer assessment was used.…”

Section: Patient Assessmentmentioning

confidence: 99%

“…3,5,17 Various factors, such as graft material and operative technique, differ in studies, resulting in diverse clinical and structural outcomes. 20,31,40,42 Some studies have reported satisfactory or worsened clinical outcomes after conventional partial repair. 4,6,8,10,13,16,44,46 Therefore, controversy remains regarding the operative indications for graft surgery and partial repair.…”

mentioning

confidence: 99%

Irreparable Large to Massive Rotator Cuff Tears With Low-Grade Fatty Degeneration of the Infraspinatus Tendon: Minimum 7-Year Follow-up of Fascia Autograft Patch Procedure and Partial Repair

et al. 2021

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Background: In shoulders with irreparable massive rotator cuff tears (RCTs) with high-grade fatty degeneration (Goutallier stage 3 or 4) of the supraspinatus tendon and low-grade fatty degeneration (Goutallier stage 1 or 2) of the infraspinatus tendon (ISP), arthroscopic patch grafting (PG) has been reported as superior to partial repair (PR) regarding the ISP retear rate at short-term to midterm follow-up. However, the longer term outcomes are unclear. Purpose: To compare clinical and structural outcomes in the PG and PR groups at a minimum of 7 years postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 24 patients in the PG group and 24 patients in the PR group. We primarily used the Constant score for clinical outcomes and performed magnetic resonance imaging for structural outcomes in the PG and PR groups. The risk factors for a retear of the ISP were identified by univariate and multivariate (forward stepwise selection method) logistic regression analyses. We primarily compared values at midterm follow-up (<4 years) with values at the final follow-up (minimum 7 years) for each patient. Results: The mean midterm and final follow-up times for the PG group were 41.0 and 95.1 months, respectively, compared with 35.7 and 99.3 months, respectively, for the PR group. We found significant differences for the midterm and final follow-up Constant total scores in the PG and PR groups (midterm follow-up: 79.1 vs 69.9, respectively [ P = .001]; final follow-up: 76.0 vs 65.3, respectively [ P = .006]) and in the Constant strength scores (midterm follow-up: 14.6 vs 8.5, respectively [ P < .001]; final follow-up: 13.1 vs 8.3, respectively [ P = .001]). Treatment group (PR) was a significant predictor of an ISP retear in the logistic regression analysis (odds ratio, 3.545; P = .043). Conclusion: Patients with low-grade massive RCTs treated with PG or PR improved significantly in terms of clinical outcomes at the midterm and final follow-up time points. However, Constant scores were significantly better in the PG group at the final follow-up.

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“…For example, in Germany, allografts are subjected to regulations based on transplantation law. In Japan, the use of allografts is also not approved and therefore the use of autografts is common [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Based on the recent literature, allografts made of acellular human dermis are thought to provide the most beneficial clinical outcome with low rerupture rates compared to other scaffolds [ 14 – 16 ]. In the current literature, the clinical outcome of xenografts is discussed controversially [ 7 , 17 , 18 ]. Thus, the source of the graft plays an important role [ 4 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Evaluation of Different Collagen Scaffolds in an Achilles Tendon Defect Model

Gabler

Sass

Gierschner

et al. 2018

BioMed Research International

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In the present study, a newly introduced bovine cross-linked collagen scaffold (test material) was investigated in vivo in an Achilles tendon defect model and compared to a commercially available porcine collagen scaffold (control material). In total, 28 male Sprague Dawley rats (about 400 g) were examined. The defined Achilles tendon defect of 5 mm of the right hind limb was replaced by one of the scaffold materials. After euthanasia, the hind limbs were transected for testing. Biomechanical evaluation was carried out via tensile testing (n = 8 each group, observation time: 28 days). Nonoperated tendons from the bilateral side were used as a control (native tendon, n = 4). For the histological evaluation, 12 animals were sacrificed at 14 and 28 days postoperatively (n = 3 each group and time point). Stained slices (Hematoxylin & Eosin) were evaluated qualitatively in terms of presence of cells and cell migration into scaffolds as well as structure and degradation of the scaffold. All transected hind limbs were additionally analyzed using MRI before testing to verify if the tendon repair using a collagen scaffold was still intact after the observation period. The maximum failure loads of both scaffold materials (test material: 54.5 ± 16.4 N, control: 63.1 ± 19.5 N) were in the range of native tendon (76.6 ± 11.6 N, p ≥ 0.07). The stiffness of native tendons was twofold higher (p ≤ 0.01) and the tear strength was approximately fivefold higher (p ≤ 0.01) compared to the repaired tendons with both scaffolds. Histological findings indicated that neither the test nor the control material induced inflammation, but the test material underwent a slower remodeling process. An overall repair failure rate of 48% was observed via MRI. The experimental data of the newly developed test material showed similar outcomes compared to the commercially available control material. The high repair failure rate indicated that MRI is recommended as an auxiliary measurement tool to validate experimental data.

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Healing rate and clinical outcomes of xenografts appear to be inferior when compared to other graft material in rotator cuff repair: a meta-analysis

Cited by 10 publications

References 52 publications

Biomechanical, Biochemical, and Cell Biological Evaluation of Different Collagen Scaffolds for Tendon Augmentation

Biomechanical, Biochemical, and Cell Biological Evaluation of Different Collagen Scaffolds for Tendon Augmentation

Irreparable Large to Massive Rotator Cuff Tears With Low-Grade Fatty Degeneration of the Infraspinatus Tendon: Minimum 7-Year Follow-up of Fascia Autograft Patch Procedure and Partial Repair

In Vivo Evaluation of Different Collagen Scaffolds in an Achilles Tendon Defect Model

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