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Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Reza Ojaghi, MD MSc FRCSC
UNITED STATES

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Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Reza Ojaghi, MD MSc FRCSC, UNITED STATES Sarah Remedios, MSc, PhD(c), CANADA Ivan Wong, MD, FRCSC, MACM, Dip. Sports Med, CANADA

Dalhousie University , Halifax, Nova Scotia , CANADA

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Anatomic Location

Shoulder Rotator Cuff

Treatment / Technique

Repair / Reconstruction Allograft Sutures / Knots / Anchors

Diagnosis / Condition

Tears

Diagnosis Method

Physical Examination MRI

Summary: Rotator cuff repair with dermal allograft augmentation shows improved healing and reduced retear rates compared to standard repair, leading to better patient outcomes

Introduction

Patch augmentation with rotator cuff repair may improve outcomes compared to rotator cuff repair alone due to an increase in mechanical and/or biological support. The augmentation provides additional strength to the repair site and may enhance the healing environment through biological factors. Some literature supports greater outcomes for augmentation; however, more research is needed to determine the specific benefits of augmentation with dermal allograft compared to standard rotator cuff repair. Current evidence remains inconclusive due to variations in study designs, patient populations, and types of grafts used. This study aims to evaluate the outcomes of patients who underwent rotator cuff repair with and without augmentation with dermal allograft, focusing on both structural healing and clinical function.

Methodology

In a retrospective analysis, 25 patients were included in the rotator cuff repair with augmentation (AUG), with an additional 25 randomly selected for the repair (RCR) group. Tendon tear size was determined from pre-operative MRIs, and healing and fatty infiltration were assessed post-operatively. The Western Ontario Rotator Cuff Index (WORC) was collected pre- and post-operatively. All outcomes were statistically analyzed between groups.

Results

Pre-operative tear characteristics and demographics were similar between the two groups. Post-operatively, the AUG group demonstrated superior healing compared to the RCR group (p < 0.05), with less than 15% of patients showing partial or complete retear in the AUG group compared to 50% in the RCR group. Regarding rotator cuff fatty infiltration, less than 10% of patients in both groups showed progression, with no significant difference. All patients showed improved WORC scores post-operatively at a minimum of 2 years, with the AUG group demonstrating slightly better improvement than the RCR group.

Conclusion

These results suggest that patch augmentation with dermal allograft may offer enhanced structural support and healing in rotator cuff repairs, potentially leading to better long-term outcomes in terms of tendon integrity and shoulder function. Augmentation appears to reduce the retear rates and improve healing, which could translate to better patient satisfaction and functional outcomes over time. However, further research with larger sample sizes, longer follow-up periods, and additional functional outcomes is needed to fully establish the clinical benefits of this technique compared to standard rotator cuff repair. Future studies should also consider the cost-effectiveness and patient-specific factors that may influence the decision to use augmentation in rotator cuff repairs.

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Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Introduction

Methodology

Results

Conclusion

Shoulder Rotator Cuff ePosters

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Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Enhancing Rotator Cuff Repair With Dermal Allograft Augmentation: Healing & Patient Outcomes

Introduction

Methodology

Results

Conclusion