Revision of a Failed Latissimus Dorsi Transfer for a Massive Rotator Cuff Tear With Arthroscopic Anatomic Bridging Reconstruction Using an Acellular Human Dermal Matrix Allograft

John, Rakesh; Coady, Catherine; Wong, Ivan

doi:10.1016/j.eats.2019.06.007

Cited by 4 publications

(8 citation statements)

References 17 publications

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“…With the population aging, the repair of the rotator cuff tears has begun one of the most common intervention in orthopedic surgery. Superior capsule reconstruction is a new technique described in 2016 to address irreparable supra‐spinatus or infra‐spinatus tears, that are very difficult to manage, especially in more active patients: treatment options include patch augmentation, partial repair, or reverse shoulder arthroplasty 37,38 . The hADM patches have been used in this intervention to restore the natural superior constraint of the superior translation observed in massive rotator cuff tears consequently affecting the normal biomechanics and function of the shoulder.…”

Section: Upper Extremitiesmentioning

confidence: 99%

“…to address irreparable supra-spinatus or infra-spinatus tears, that are very difficult to manage, especially in more active patients: treatment options include patch augmentation, partial repair, or reverse shoulder arthroplasty. 37,38 The hADM patches have been used in this intervention to restore the natural superior constraint of the superior translation observed in massive rotator cuff tears consequently affecting the normal biomechanics and function of the shoulder. A significant impact on functional outcomes according to both clinical scores, MRI appearance and histological analysis, was reported.…”

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

“…A significant impact on functional outcomes according to both clinical scores, MRI appearance and histological analysis, was reported. 37,38 In particular, patients with intact hADM grafts covering the tuberosity have lower pain (VAS score) and higher functional scores with a lower rate of re-intervention in the short-term follow-up, compared with other methods. Latissimus dorsi tendon transfer is often done as a salvage procedure for failed repairs of massive rotator cuff tears, and its rupture represents an uncommon complication with limited literature management options, especially in the young.…”

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

“…Recently, a new technique that uses an hADM grafts for arthroscopic anatomic bridging reconstruction was proposed by John et al as a safe alternative that did not show any further fatty deterioration nor muscle atrophy in large to massive rotator cuff tears. 38…”

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

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The use of human acellular dermal matrices in advanced wound healing and surgical procedures: State of the art

Tognetti

Pianigiani

Ierardi

et al. 2021

Dermatologic Therapy

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Wound closure after post-traumatic injuries and/or localized at peculiar body sites (head-and-neck, oral cavity, legs) are particularly challenging and can often be delayed due to local and systemic factors. In case of deep wounds and/or hard-to-heal wounds, grafting of dermal acellular matrices (ADM) is often needed. Though a great variety of synthetic and semisynthetic dermal and skin equivalents are available, viable human dermis, is still considered the most physiological alternative to replace the loss of autologous dermis, by acting as a physiological scaffold that add structural support to soft tissues. To date, human ADMs (hADMs) have been employed in the reconstruction of skin defects affecting almost all body sites, ranging from visceral sites to the skin and subcutaneous tissues. This review aims to investigate the use of hADM at different body sites and their peculiar advantages. A literature search was using the search terms "acellular dermal matrices", "dermal regeneration", "advances wound healing", "human acellular dermal matrices surgery". A total of 50 out of 150 papers was included. Based on the current body if evidence, hADMs appear to bring several advantages, such as: protection of deep structures (eg, tendons, bones, cartilage and nerves); stimulation of a functional new dermis (rather than a scar); reduction of wound closure time; control of pain and exudate. Finally, hADMs may represent the best treatment option for hard-to-heal wound not only in terms of efficacy and patient satisfaction bout also in terms of sanitary costs, especially across Europe, where hADMs cannot be commercialized as medical devices.

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Section: Upper Extremitiesmentioning

confidence: 99%

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

Section: Superior Capsule Reconstruction Is a New Technique Described...mentioning

confidence: 99%

See 2 more Smart Citations

The use of human acellular dermal matrices in advanced wound healing and surgical procedures: State of the art

Tognetti

Pianigiani

Ierardi

et al. 2021

Dermatologic Therapy

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“…6, Table 1). A modified Ivan Wong 17 technique was performed. Four different colors of short‐tailed interference knots (STIK) were prepared by tying mulberry‐type knots over a Wissinger rod.…”

Section: Surgical Techniquementioning

confidence: 99%

Arthroscopic Superior Capsule Reconstruction and Rotator Cuff Repair to Restore Static and Dynamic Stability of the Shoulder

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Hou

Tang

et al. 2020

Orthopaedic Surgery

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Objective: Treatment of massive irreparable rotator cuff tears (RCT) has shown limited clinical success and a variety of subsequent complications. Superior capsule reconstruction (SCR) has been proved to reestablish superior stability but does not restore the dynamic force or shoulder kinematics. There are numerous reports of the short-term failure of SCR grafts at the glenoid side, which relate to the non-biological healing of grafts. To restore both dynamic and static stability and to provide biologic augmentation, an integrated procedure for massive irreparable RCT using an Achilles tendon-bone allograft (ATBA) was developed. Method: This was a retrospect study completed between October 2019 and April 2020. A 71-year-old woman with massive and irreparable rotator cuff tears was enrolled in our study. The ATBA was folded into a double-layer structure. The superior layer (proximal portion) served as a bridge patch to dynamic the glenohumeral joint, while the inferior layer (distal portion) served as the superior capsule to restore static stability of glenohumeral joint. To enhance biologic healing on the glenoid side, we fixed the calcaneus of the graft on the superior-posterior side of the superior glenoid rim. The recovery of shoulder function (including strength, range of motion, acromiohumeral interval, and fatty infiltration) was assessed at 6 months postoperation. Result: At 6-month follow-up, the patient's strength had improved significantly (from abduction of grade 3 preoperatively to grade 4 at 6 months). Radiographic analysis showed an increase in the acromiohumeral interval from 3 to 7 mm. Magnetic resonance imaging revealed an intact graft, with the thickness of the ligament part maintained (at 6-7 mm). Most importantly, recovery of atrophy and fatty infiltration of the supraspinatus were observed. No graft tears were observed on the glenoid side. Conclusion: This technique could provide a preferable treatment option by restoring shoulder kinematics and augmentating biological healing for patients with massive irreparable RCT.

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Can the Sterilization Protocol Be Improved to Enhance the Healing of Allograft Tendons? An In Vivo Study in Rabbit Tendons

Zhang,

Xu,

Zhao

et al. 2024

Clin Orthop Relat Res

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Background Peracetic acid and irradiation are common sterilization methods for allograft tendons; however, under some conditions, both methods adversely affect the fiber arrangement and ultimate load of the tendon. An in vitro study showed that low-dose peracetic acid combined with irradiation may be less detrimental to allograft tendon structure and properties, possibly because the breakdown of peracetic acid can lead to an enlargement of the interstitial spaces and an increase in porosity. Questions/purposes Using a rabbit Achilles tendon model, we asked: What is the effect of peracetic acid-ethanol combined irradiation on (1) the histopathology and fiber diameter of the allograft tendon, (2) tensile creep and load-to-failure biomechanical properties of allograft tendons, and (3) healing of the treated tendon in vivo compared with fresh-frozen allograft and peracetic acid-ethanol sterilization at 4 and 8 weeks? Methods The Achilles tendons used in this study were sourced from euthanized 10-week-old male New Zealand White rabbits previously used for ophthalmic experiments. All allografts were divided into three groups: fresh-frozen group (control group, n = 20), peracetic acid-ethanol sterilization group (n =20), and peracetic acid-ethanol combined irradiation group (n = 20). The sterilization protocols were performed per a predetermined plan. In the peracetic acid-ethanol sterilization group, the tendon tissues were covered with the peracetic acid-ethanol sterilization solution (1% peracetic acid for 30 minutes). In the peracetic acid-ethanol combined irradiation group, the tendon tissues were covered with the peracetic acid-ethanol sterilization solution (0.2% peracetic acid for 30 minutes) and were subjected to 15 kGy gamma irradiation. Thirty 10-week-old male New Zealand White rabbits received bilateral Achilles tendon allografts surgically. Tendon samples from each group were harvested at 4 weeks (n = 30) and 8 weeks (n = 30) postoperatively. For each timepoint, eight tissues were used for histologic staining and electron microscopy, 15 tissues were used for biomechanical testing, and seven tissues were used for hydroxyproline assay and quantitative polymerase chain reaction. Histopathology was determined qualitatively by hematoxylin and eosin and Masson staining, while fiber diameter was measured quantitatively by transmission electron microscopy. Biomechanical properties were measured using cyclic loading tests and load-to-failure tests. The healing outcome was quantitatively judged through healing-related genes and proteins. Results At 4 weeks and 8 weeks postoperatively, the peracetic acid-ethanol combined irradiation group visually demonstrated the best continuity and minimal peripheral adhesions. Histologic staining showed that tendon fibers in the peracetic acid-ethanol combined irradiation group maintained consistent alignment without notable disruptions or discontinuities, and there was a qualitatively observed increase in the number of infiltrating cells compared with the control group at the 4-week timepoint (444 ± 49 /mm2 versus 256 ± 43 /mm2, mean difference 188 /mm2 [95% confidence interval 96 to 281]; p < 0.001). At 8 weeks postoperatively, the tendon fiber diameter in the peracetic acid-ethanol combined irradiation groups was similar to that of the control group (0.23 ± 0.04 µm versus 0.21 ± 0.03 µm, mean difference 0.02 µm [95% CI -0.04 to 0.08]; p = 0.56). At 8 weeks postoperatively, the peracetic acid-ethanol combined irradiation group exhibited better properties in terms of both ultimate load (129 ± 15 N versus 89 ± 20 N, mean difference 40 N [95% CI 7 to 73]; p = 0.02) and energy absorption density (17 ± 6 kJ/m2 versus 8 ± 4 kJ/m2, mean difference 8 kJ/m2 [95% CI 0.7 to 16]; p = 0.004) compared with the control group. Gene expression analysis revealed higher expression levels of COL1A1 (2.1 ± 0.8 versus 1.0 ± 0, mean difference 1.1 [95% CI 0.1 to 2.1]; p = 0.003) and MMP13 (2.0 ± 0.8 versus 1.0 ± 0, mean difference 1.0 [95% CI 0.4 to 1.6]; p = 0.03) in the peracetic acid-ethanol combined irradiation group than in the control group. There was a higher amount of collagen Type I in tendons treated with peracetic acid-ethanol combined irradiation than in the control group (0.36 ± 0.03 versus 0.31 ± 0.04, mean difference 0.05 [95% CI 0.01 to 0.09]; p = 0.02). Conclusion Treatment with peracetic acid-ethanol combined irradiation did not have any discernible adverse effect on the histology, fiber diameter, enzymatic resistance, collagen content, or biomechanical strength of the allograft tendons compared with the control group. Peracetic acid-ethanol combined irradiation treatment had a positive impact on remodeling of the extracellular matrix and realignment of collagen fibers. Clinical Relevance This sterilization method could be helpful to expand the scope and frequency with which allogeneic materials are applied. The long-term healing effect and strength of allograft tendons must be tested before clinical use, and it is necessary to conduct comparative studies on autografts and synthetic materials that are currently widely used clinically.

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Revision of a Failed Latissimus Dorsi Transfer for a Massive Rotator Cuff Tear With Arthroscopic Anatomic Bridging Reconstruction Using an Acellular Human Dermal Matrix Allograft

Cited by 4 publications

References 17 publications

The use of human acellular dermal matrices in advanced wound healing and surgical procedures: State of the art

The use of human acellular dermal matrices in advanced wound healing and surgical procedures: State of the art

Arthroscopic Superior Capsule Reconstruction and Rotator Cuff Repair to Restore Static and Dynamic Stability of the Shoulder

Can the Sterilization Protocol Be Improved to Enhance the Healing of Allograft Tendons? An In Vivo Study in Rabbit Tendons

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