Michael E Steinhaus1, Eric C Makhni2, Brian J Cole3, Anthony A Romeo3, Nikhil N Verma3. 1. Hospital For Special Surgery, New York, New York, U.S.A. 2. Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: ericmakhnimd@gmail.com. 3. Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois, U.S.A.
Abstract
PURPOSE: To provide a comprehensive review of clinical outcomes and retear rates after patch use in rotator cuff repair, and to determine the differences between available graft types and techniques. METHODS: A systematic review was conducted from database (PubMed, Medline, Scopus, Embase) inception to January 2015 for English-language articles reporting outcome data with 9 months' minimum follow-up. Studies were assessed by 2 reviewers who collected pertinent data, with outcomes combined to generate frequency-weighted means. RESULTS: Twenty-four studies met the inclusion criteria. The frequency-weighted mean age was 61.9 years with 35.4 months' follow-up. The mean improvements in postoperative range of motion in the forward elevation, abduction, external rotation, and internal rotation planes were 58.6°, 66.2°, 16.6°, and 16.1°, respectively, and postoperative abduction strength improved by 3.84 kg. American Shoulder and Elbow Surgeons, University of California-Los Angeles, Constant, Penn, and Oxford scores improved by 39.3, 10.7, 40.8, 34.4, and 17.6, respectively. Augmentation and interposition techniques showed similar improvements in range of motion, strength, and patient-reported outcomes (PROs), whereas xenografts showed less improvement in PROs compared with other graft types. Studies reported improvements in pain and activities of daily living (ADLs), with greater than 90% overall satisfaction, although few patients (13%) were able to return to preinjury activity. Whereas interposition and augmentation techniques showed similar improvements in pain and ADLs, xenografts showed less improvement in ADLs than other graft types. The overall retear rate was 25%, with rates of 34% and 12% for augmentation and interposition, respectively, and rates of 44%, 23%, and 15% for xenografts, allografts, and synthetic grafts, respectively. CONCLUSIONS: We report improvements in clinical and functional outcomes, with similar results for augmentation and interposition techniques, whereas xenografts showed less improvement than synthetic grafts and allografts in PROs and ADLs. Retear rates may be lower with the interposition technique or in patients with synthetic grafts or allografts. LEVEL OF EVIDENCE: Level IV, systematic review of Level II through IV studies.
PURPOSE: To provide a comprehensive review of clinical outcomes and retear rates after patch use in rotator cuff repair, and to determine the differences between available graft types and techniques. METHODS: A systematic review was conducted from database (PubMed, Medline, Scopus, Embase) inception to January 2015 for English-language articles reporting outcome data with 9 months' minimum follow-up. Studies were assessed by 2 reviewers who collected pertinent data, with outcomes combined to generate frequency-weighted means. RESULTS: Twenty-four studies met the inclusion criteria. The frequency-weighted mean age was 61.9 years with 35.4 months' follow-up. The mean improvements in postoperative range of motion in the forward elevation, abduction, external rotation, and internal rotation planes were 58.6°, 66.2°, 16.6°, and 16.1°, respectively, and postoperative abduction strength improved by 3.84 kg. American Shoulder and Elbow Surgeons, University of California-Los Angeles, Constant, Penn, and Oxford scores improved by 39.3, 10.7, 40.8, 34.4, and 17.6, respectively. Augmentation and interposition techniques showed similar improvements in range of motion, strength, and patient-reported outcomes (PROs), whereas xenografts showed less improvement in PROs compared with other graft types. Studies reported improvements in pain and activities of daily living (ADLs), with greater than 90% overall satisfaction, although few patients (13%) were able to return to preinjury activity. Whereas interposition and augmentation techniques showed similar improvements in pain and ADLs, xenografts showed less improvement in ADLs than other graft types. The overall retear rate was 25%, with rates of 34% and 12% for augmentation and interposition, respectively, and rates of 44%, 23%, and 15% for xenografts, allografts, and synthetic grafts, respectively. CONCLUSIONS: We report improvements in clinical and functional outcomes, with similar results for augmentation and interposition techniques, whereas xenografts showed less improvement than synthetic grafts and allografts in PROs and ADLs. Retear rates may be lower with the interposition technique or in patients with synthetic grafts or allografts. LEVEL OF EVIDENCE: Level IV, systematic review of Level II through IV studies.
Authors: Kyle R Duchman; Dayne T Mickelson; Barrett A Little; Thomas W Hash; Devin B Lemmex; Alison P Toth; Grant E Garrigues Journal: Skeletal Radiol Date: 2018-07-05 Impact factor: 2.199
Authors: Jonathan A Cook; Mathew Baldwin; Cushla Cooper; Navraj S Nagra; Joanna C Crocker; Molly Glaze; Gemma Greenall; Amar Rangan; Lucksy Kottam; Jonathan L Rees; Dair Farrar-Hockley; Naomi Merritt; Sally Hopewell; David Beard; Michael Thomas; Melina Dritsaki; Andrew J Carr Journal: Health Technol Assess Date: 2021-02 Impact factor: 4.014
Authors: A Ali Narvani; Mohamed A Imam; Ioannis Polyzois; Tanaya Sarkhel; Rohit Gupta; Ofer Levy; Paolo Consigliere Journal: Arthrosc Tech Date: 2017-05-29
Authors: Nathaniel A Dyment; Jennifer G Barrett; Hani A Awad; Catherine A Bautista; Albert J Banes; David L Butler Journal: J Orthop Res Date: 2020-07-01 Impact factor: 3.494
Authors: Dai Fei Elmer Ker; Dan Wang; Anthony William Behn; Evelyna Tsi Hsin Wang; Xu Zhang; Benjamin Yamin Zhou; Ángel Enrique Mercado-Pagán; Sungwoo Kim; John Kleimeyer; Burhan Gharaibeh; Yaser Shanjani; Drew Nelson; Marc Safran; Emilie Cheung; Phil Campbell; Yunzhi Peter Yang Journal: Adv Funct Mater Date: 2018-03-30 Impact factor: 18.808
Authors: Eric R Wagner; Jarret M Woodmass; Kathryn M Welp; Michelle J Chang; Bassem T Elhassan; Laurence D Higgins; Jon J P Warner Journal: JBJS Essent Surg Tech Date: 2018-04-25
Authors: Samuel E Broida; Aidan P Sweeney; Michael B Gottschalk; Jarret M Woodmass; Eric R Wagner Journal: Eur J Orthop Surg Traumatol Date: 2021-08-09