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Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review

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Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review

Olivia Bono, BS, UNITED STATES Bryan Jenkin, BA, UNITED STATES Julaine Forlizzi , MD, UNITED STATES Albert Mousad, BS, UNITED STATES Stephen Le Breton, BS, UNITED STATES Glen Ross, MD, UNITED STATES Sarav Shah, MD, UNITED STATES

New England Baptist Hospital , Boston, Massachusetts, UNITED STATES

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Shoulder Rotator Cuff

Diagnosis / Condition

Tears

Treatment / Technique

Arthroscopy

Summary: Clinically, while there remains scant data at long term follow-up in favor of PRP, utilization of innovative delivery techniques may reduce the risk of arthroscopic washout of PRP and has been shown to potentially improve retear rates.

Purpose

Biologic healing remains a significant challenge as tendon tear recurrence is associated with clinical deterioration in the long-term. Injectable biologic augmentation has been hypothesized to improve tissue quality at the suture-tendon interface. The purpose of this study is to systematically review updated preclinical and clinical evidence from 2010 to 2022 regarding the utilization of injectable biologic supplementation in rotator cuff repair.

Methods

A systematic review was conducted following PRISMA guidelines. Two reviewers performed relevant paper selection with a third arbitrating disputes. In total 40 studies, consisting of 29 preclinical and 11 clinical, were included in the study.

Results

Injectables reported included growth factors, bone marrow- & adipose-derived mesenchymal stem cells (ADSC), and other agents (namely platelet-rich plasma (PRP) & hyaluronic acid). The most common findings for preclinical injectables were increased load-to-failure and improved collagen histological quality. Clinically, all eleven clinical studies (10 PRP, 1 ADSC) indicated no adverse events with similar or improved patient-reported outcomes measures compared to control repairs. In one study, a concentrated PRP globule with fibrin matrix was shuttled over a suture to maintain concentrated PRP at the repair site and demonstrated a statistically significant decrease in retears (P=0.03) on MRI evaluation at 31-month follow-up. A matched cohort study investigating augmentation with ADSCs demonstrated a significantly lower retear rate in the ADSC augmented group than in the control repair group at 28-month follow-up (P<.001).

Conclusion

Clinically, while there remains scant data at long term follow-up in favor of PRP, utilization of innovative delivery techniques may reduce the risk of arthroscopic washout of PRP and has been shown to potentially improve retear rates. Further, ADSCs have been shown to reduce retear rates at 28-month follow-up.

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Effect of Polydeoxyribonucleotide and Polynucleotide on Healing and Fatty Degeneration of Rotator Cuff in Hypercholesterolemic Rat model ePoster Presentation Jung-Taek Hwang, MD, PhD, KOREA, REPUBLIC OF
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Minimal Clinically Important Difference (MCID) of the Oxford Shoulder Score for Arthroscopic Rotator Cuff Repair at 5 Years Post-Operatively ePoster Presentation Merrill Lee, MBBS, MRCS(Edin), SINGAPORE Khai Cheong Wong, MBChB, MRCS (Eng), SINGAPORE Gek Hsiang Lim, MSc, SINGAPORE Benjamin Fu Hong Ang, MBBS, MRCS, MMed(Orth), FRCS(Orth), SINGAPORE Jerry Chen, MBBS, MRCS(Edin), MMed(Orth), SINGAPORE Paul Chee Cheng Chang, MBBS,FRCS, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
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Usability of the Dynamic Assessment of the Supraspinatus Using Ultrasonography ePoster Presentation Junsuke Miyasaka, MS, JAPAN Ryuzo Arai, MD, JAPAN Yuji Yoshioka, MS, JAPAN Takuma Yuri, PhD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN
Superiore Capsular Reconstruction Using the Long Head Of Biceps Tendon With Good Clinical and Radiographical Outcome ePoster Presentation Andreas Voss, MD, GERMANY Laura Hauer, Student , GERMANY Laura Weber, Student , GERMANY Stefan Greiner, MD, Prof., GERMANY
Clinical and Radiological Outcomes of Arthroscopic Repair for Delaminated Rotator Cuff Tear vs. Non-Delaminated Tear ePoster Presentation Kengo Kirimura, MD, JAPAN
Allograft Augmentation of Irreparable Supraspinatus Tendon Tears, High Graft Healing Rate with Improved Clinical Function: A Case Series Study ePoster Presentation Mark David Haber, MBBS, FRACS, AUSTRALIA Andres Eduardo Rodriguez Borgonovo, MD, AUSTRALIA Noam Rosen, MD, AUSTRALIA Dvir Shalom Ben Shabat, MD, AUSTRALIA
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Cuff Plus Procedure for the Treatment of Large to Massive Rotator Cuff Tears ePoster Presentation Francesco De Filippo, MD, ITALY Marcello Motta, MD, ITALY Marco Adriani, MD, ITALY Emanuele Maggini, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY
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Musculotendinous Junction Rotator Cuff Tear - Early Functional Outcomes And Repair Technique In A Single-Surgeon Case Series Of 6 Patients ePoster Presentation Cheryl Gatot, MD, SINGAPORE Hannah Marian Lie, Medical Student, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Conservative Treatment For Full-Thickness Supraspinatus Tendon Tears: Efficacy And Prognostic Factors ePoster Presentation Thomas Kappe, MD, Prof., GERMANY Mirco Sgroi, MD, GERMANY Heiko Reichel, Prof., GERMANY
Footprint Preservation Enhances Functional and Structural Outcome After Rotator Cuff Repair ePoster Presentation Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Alberto Guizzi, ITALY Francesco DeFilippo, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY
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Evaluated The Effective Of Tendon Healing After Rotator Cuff Repair Used Modified Mason-Allen Suture Technique Combined With Microfracture Procedure ePoster Presentation Quyet Tran, MD, VIETNAM Viet Duc Vu, MD, VIETNAM Trần Trung Dũng, Professor, MD, PhD, VIETNAM
Does Rotator Cuff Tear Morphology Affect Clinical Outcomes Post-Surgical Repair In Large To Massive Tears? ePoster Presentation Mark H.X. Yeo, MBBS, SINGAPORE Shawn Js Seah, MBBS, SINGAPORE Merrill Lee, MBBS, MRCS(Edin), SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Scaffold and Graft-Based Biologic Augmentation of Rotator Cuff Repair: An Updated Systematic Review and Meta-Analysis for 2010-2022 ePoster Presentation Albert Mousad, BS, UNITED STATES Olivia Bono, BS, UNITED STATES Krishna Mandalia, BS , UNITED STATES Julaine Forlizzi , MD, UNITED STATES Glen Ross, MD, UNITED STATES Sarav Shah, MD, UNITED STATES
Factors Affecting Clinical Results of Re-Tear Cases After Arthroscopic Repair of Large and Massive Rotator Cuff Tears ePoster Presentation Hideyasu Kaieda, MD, JAPAN Hironori Kakoi, MD, PhD, JAPAN Yasunari Fujii, MD, JAPAN
Gender Analysis of Rotator Cuff Repair Utilization and Outcomes ePoster Presentation Samuel S Rudisill, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Jacob Linker, BA, UNITED STATES Sara Naessig, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Nathan J Cherian, MD, UNITED STATES Zachary Logan LaPorte, BA, UNITED STATES Matthew J Best, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Partial Thickness Rotator Cuff Tears: Retear Rate and Functional Outcome Following an Arthroscopic Tear Completion and Suture-Bridge Technique Suggests a Specific Rehabilitation Plan ePoster Presentation Mark David Haber, MBBS, FRACS, AUSTRALIA Andres Eduardo Rodriguez Borgonovo, MD, AUSTRALIA Noam Rosen, MD, AUSTRALIA Dvir Shalom Ben Shabat, MD, AUSTRALIA
Comparison of Tear Characteristics, Outcome Parameters and Healing In Traumatic and Non-Traumatic Rotator Cuff Tear: A Prospective Cohort Study ePoster Presentation Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA
Influence of the Pattern of Rotator Cuff Tear in the Stability Obtained After Arthroscopic Superior Capsular Reconstruction: A Computational Analysis ePoster Presentation Madalena João Antunes, MEng, PORTUGAL Carlos Quental, PhD, Prof., PORTUGAL João Folgado, PhD, Prof., PORTUGAL Clara Azevedo, MD, PhD, PORTUGAL Ana Catarina Ângelo, MD, PORTUGAL
Virtual Reality Rehabilitation for Patients with Shoulder Disorders ePoster Presentation Umile Giuseppe Longo, MD, MSc, PhD, Prof., ITALY Arianna Carnevale, Eng, ITALY Vincenzo Candela, ITALY Carlo Casciaro, MD, ITALY Giuseppe Salvatore, MD, PhD, ITALY Alessandra Berton, MD, ITALY Emiliano Schena, Eng, ITALY Marco Carli, Prof., ITALY Vincenzo Denaro, MD, PhD, Prof., ITALY
Primary Cuff Repair Augmented With Balloon Spacer in a Majority Massive Rotator Cuff Tear Series - A Short Term Outcome and Imaging Study ePoster Presentation Seng Juong Wong, MBChB, MRCS, SINGAPORE Hannah Marian Lie, Medical Student, SINGAPORE Muhammad Danish Bin Massuryono, Medical Student, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Surgical Outcome Following Arthroscopic Rotator Cuff Tear Repair in a Low-Income Population: Quality of Life Improvement ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Thresholds For Preoperative Opioid Use In Arthroscopic Rotator Cuff Repair That Negatively Influence Postoperative Clinical Outcomes ePoster Presentation Michael Andrew Fox, MD, UNITED STATES Justin James Greiner, MD, UNITED STATES Noel Carlos, MS, UNITED STATES Zachary J Herman, MD, UNITED STATES Nicholas P Drain, MD, UNITED STATES Shaquille Charles, MSc, UNITED STATES Bryson P. Lesniak, MD, UNITED STATES Albert Lin, MD, UNITED STATES
An Analysis Of Shoulder Surgeon Volume On Competency, Hospital Costs And Adverse Events: A Systematic Review ePoster Presentation Moin Khan, MD, MSc, FRCSC, CANADA Haseeb Ahmed Faisal, BHSc(Cand), CANADA Ajaykumar Shanmugaraj, BSc, CANADA Shahrukh Khan, BHSc, CANADA Loiy Alkhatib , MD, UNITED ARAB EMIRATES Mahdi Alsaffar, KUWAIT Timothy Leroux, MD, MEd, FRCSC, CANADA
Radiological Healing of The Rotator Cuff On MRI Does Not Correlate With Functional Outcomes After Arthroscopic Rotator Cuff Repair ePoster Presentation Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA
Marrow-Derived Augmentation for Primary Rotator Cuff Repair: Systematic Review and Meta-Analysis ePoster Presentation Stephen Le Breton, BS, UNITED STATES Julaine Forlizzi , MD, UNITED STATES Olivia Bono, BS, UNITED STATES Albert Mousad, BS, UNITED STATES Sophie Kush , BS, UNITED STATES Alaia Christensen, BS, MD, UNITED STATES Arun Ramappa, MD, UNITED STATES Glen Ross, MD, UNITED STATES Sarav Shah, MD, UNITED STATES
Clinical Results And Retear Rates After Arthroscopic Rotator Cuff Repair With Manipulation Under Anesthesia ePoster Presentation Yoshitsugu Takeda, MD, PhD, JAPAN Naoto Suzue, MD, PhD, JAPAN
Effects of an Abduction Brace After Shoulder Surgery on Gait Parameters and Functional Mobility ePoster Presentation Filippo Familiari, MD, Prof., ITALY Michele Mercurio, Prof., MD, ITALY Francesca Greco, MSc, ITALY Alessandro Barone, MD, Prof., ITALY Gian Pietro Emerenziani, PT, ITALY Olimpio Galasso, MD, Prof., ITALY Giorgio Gasparini, MD, Prof., ITALY
Tenodesis of Long Head of Biceps Tendon Does Not Affect Outcome after Rotator Cuff Reconstruction ePoster Presentation Mirco Sgroi, MD, GERMANY Thomas Kappe, MD, Prof., GERMANY Thomas Caffard, MD, GERMANY Marius Ludwig, MD, GERMANY Heiko Reichel, Prof., GERMANY
Non-Selective NSAIDs Provide Good Clinical Outcomes and Do Not Increase Retear rates post-arthroscopic rotator cuff repair: A systematic review and meta-analysis ePoster Presentation Shawn Js Seah, MBBS, SINGAPORE Mark H.X. Yeo, MBBS, SINGAPORE Cheryl Gatot, MD, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Cannabidiol for Post-Operative Pain Control after Arthroscopic Rotator Cuff Repair Demonstrates No Functional Deficits at 1-Year ePoster Presentation Michael J Alaia, MD, UNITED STATES Zachary I Li, BA, UNITED STATES Kinjal Vasavada, BA, UNITED STATES Michael Buldo-Licciardi, BS, UNITED STATES Eoghan T. Hurley, MB, BCh, MCh, IRELAND Guillem Gonzalez-Lomas, MD, UNITED STATES Andrew Rokito, MD, UNITED STATES Laith M. Jazrawi, MD, UNITED STATES Kevin M. Kaplan, MD, UNITED STATES
Type-II Re-Tears Found to be Higher in the Knot-Tying Suture Bridge Rotator Cuff Repair: A Systematic Review and Meta-Analysis ePoster Presentation Niti Prasathaporn, MD, THAILAND Napatpong Thamrongskulsiri, MD, THAILAND Thun Itthipanichpong, MD, THAILAND Danaithep Limskul, MD, THAILAND
Histopathology Of Long Head Of Biceps Tendon Removed During Tenodesis Demonstrates Degenerative Histopathology and Not Inflammatory Changes ePoster Presentation Maciej J K Simon, MD, PhD, GERMANY Jane Yeoh, MD, FRCSC, CANADA Michael Nimmo, MD, FRCPC, CANADA William Regan, MD FRCSc, CANADA
Efficacy of MRI Imaging Versus Reports On Surgical Decision Making In the Shoulder ePoster Presentation Maciej J K Simon, MD, PhD, GERMANY William Regan, MD FRCSc, CANADA
Muscle Edema of Retraction and Pseudo Fatty Infiltration After Traumatic Rotator Cuff Tears as an Experimental Model in Sheep ePoster Presentation Tiago Martinho, MD, SWITZERLAND Joe Chih-Hao Chiu, MD, PhD, TAIWAN Marko Nabergoj, MD, SLOVENIA Sean W.L. Ho, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), SINGAPORE Hugo Bothorel, MEng, SWITZERLAND Alexandre Lädermann, MD, SWITZERLAND
Impact of Patient Resilience on Rotator Cuff Repair Post-Operative Outcomes ePoster Presentation Ryan W. Paul, BS, UNITED STATES Michael P Campbell, MD, UNITED STATES Sydney Streicher, BA, UNITED STATES Matthew P Wallingford, BS, UNITED STATES Taylor D'Amore, MD, UNITED STATES Sean Bryan, MD, UNITED STATES Fotios P. Tjoumakaris, MD, UNITED STATES Kevin Freedman, MD, UNITED STATES
Outcome Comparison Between Arthroscopic Repair of Full-Thickness Rotator Cuff Tear and Partial-Thickness Rotator Cuff Tear ePoster Presentation Andres Eduardo Rodriguez Borgonovo, MD, AUSTRALIA Mark David Haber, MBBS, FRACS, AUSTRALIA Noam Rosen, MD, AUSTRALIA Dvir Shalom Ben Shabat, MD, AUSTRALIA
The Influence of Different Rotator Cuff Tears in Relation to Glenoid Depth on Glenohumeral Stability - A Robotic Biomechanical Analysis ePoster Presentation Sebastian Oenning, MD, GERMANY Mats Jonas Wiethölter, MD, GERMANY Jens Wermers, MD, GERMANY Alina Köhler, MD, GERMANY Sebastian Oenning, MD, GERMANY Michael J. Raschke, MD, Prof., GERMANY J. Christoph Katthagen, MD, GERMANY
Is Superior and Posterior Capsular Release More Effective Than Superior Capsular Release Alone in Arthroscopic Repair of Large to Massive Rotator Cuff Tear? ePoster Presentation Jung-Taek Hwang, MD, PhD, KOREA, REPUBLIC OF
Radiological Evaluation Of Rotator Cuff Healing and Its Clinical Correlation After Arthroscopic Repair of Rotator Cuff Tear By Single Row Technique ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Rakesh Sehrawat, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA

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Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review

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Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review

Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: Systematic Review

Purpose

Methods

Results

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