ISAKOS: 2023 Congress in Boston, MA USA

2023 ISAKOS Biennial Congress ePoster

 

Footprint Preservation Enhances Functional and Structural Outcome After Rotator Cuff Repair

Marco Adriani, MD, Brescia, Brescia ITALY
Marcello Motta, MD, Brescia ITALY
Alberto Guizzi ITALY
Francesco DeFilippo, MD, Brescia ITALY
Maristella Francesca Saccomanno, MD, PhD, Brescia ITALY
Giuseppe Milano, Prof., Brescia, BS ITALY

University of Brescia, Brescia, ITALY

FDA Status Not Applicable

Summary

Recent biomechanical studies showed that anatomic rotator cuff repair preserving remnant tendon tissue can enhance tendon-to-bone healing in animal models, Footprint preservation associated with nanofractures of the greater tuberosity enhances functional and structural outcome after rotator cuff repair.

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Abstract

Aim

to evaluate the clinical efficacy of biologic enhancement of tendon bone-healing through footprint preservation associated with nanofractures of the greater tuberosity in rotator cuff repair.

Background

Recent biomechanical studies showed that anatomic rotator cuff repair preserving remnant tendon tissue can enhance tendon-to-bone healing in animal models.

Methods

A retrospective study was conducted. Patients who underwent an arthroscopic rotator cuff repair by preserving the native humeral insertion associated with nanofractures of the greater tuberosity were included. Exclusion criteria were: partial thickness tears, irreparable tears, capsulo-labral pathologies, calcific tendonitis, gleno-humeral osteoarthritis and/or previous surgery. Primary outcome was the ASES score. Secondary outcomes were: Quick-DASH, WORC and evaluation of tendon integrity through a magnetic resonance imaging (MRI) performed six months after surgery. A paired t-test was used to compare pre and postoperative outcomes. Multivariate analysis was performed to determine which predictors were independently associated with the outcome. Significance was set at p < 0.05.

Results

The study included 15 males and 14 females. Mean age (+ SD) of patients was 61.69 + 8.89 years. Mean follow-up was 46.68 + 3.92. Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Subgroup analysis for tear size showed significant differences in the QuickDASH score (0.03). Particularly, a significant difference in the QuickDASH score could be detected between medium and big tears (p=0.008) as well as medium and massive lesions (p=0.04). No differences could be detected between big and massive tears (p= 0.35). Postoperative imaging showed healed tendons in 21 out of 29 (71.4%) MRI.

Conclusions

Footprint preservation associated with nanofractures of the greater tuberosity enhances functional and structural outcome after rotator cuff repair.