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Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

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Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

Francesco De Filippo, MD, ITALY Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Giuseppe Bertoni, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY

university of Brescia, Brescia, ITALY

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Shoulder Rotator Cuff

Treatment / Technique

Biologics

Summary: Recent studies on animal models suggested that nanofractures showed advantages in biomechanical, histological, and radiographic results compared to larger diameter microfractures; the aim of our study was to evaluate the clinical efficacy of biologic enhancement of tendon bone-healing through nanofractures of the greater tuberosity.

Background

Although it has been shown that microfractures of the greater tuberosity reduce re-tear rate after arthroscopic rotator cuff repair, recent studies on animal models suggested that nanofractures showed advantages in biomechanical, histological, and radiographic results compared to larger diameter microfractures.

Methods

A retrospective study was conducted. Patients who underwent an arthroscopic rotator cuff repair associated with nanofractures of the greater tuberosity instead of cortical abrasion 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. A subgroup analysis for tear size was also conducted. Significance was set at p < 0.05.

Results

The study included 20 males and 9 females. Mean age (+ SD) of patients was 61 + 6.9 years. Mean follow-up was 31.5 + 10.9. Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Subgroup analysis for tear size showed no differences nor in functional outcomes, neither in structural integrity. Postoperative imaging showed healed tendons in 25 out of 29 (86.2%) MRI.

Conclusions

Nanofractures of the greater tuberosity enhances functional and structural outcome after rotator cuff repair.

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Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

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Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair

Background

Methods

Results

Conclusions

More 2023 ISAKOS Congress Content