Document Detail


Rotator cuff repair augmentation using a novel polycarbonate polyurethane patch: preliminary results at 12 months' follow-up.
MedLine Citation:
PMID:  21106404     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preventing anatomic failure after rotator cuff repair (RCR) remains a challenge. Augmentation with a surgical mesh may permanently reinforce the repair and decrease failure rates. The purpose of this study is to assess the postoperative outcomes of open RCR augmented with a novel reticulated polycarbonate polyurethane patch.
MATERIALS AND METHODS: Ten patients with supraspinatus tendon tears underwent open RCR augmented with a polycarbonate polyurethane patch secured in a 6-point fixation construct placed over the repaired tendon. Patients were evaluated with preoperative and postoperative outcome measures, including the Simple Shoulder Test, visual analog pain scale, American Shoulder and Elbow Surgeons shoulder score, Cumulative Activities of Daily Living score, and University of California, Los Angeles shoulder scale, as well as range of motion. Postoperative magnetic resonance imaging was used to evaluate repair status.
RESULTS: Patients showed significant improvements in visual analog pain scale, Simple Shoulder Test, and American Shoulder and Elbow Surgeons shoulder scores at both 6 and 12 months postoperatively (P < .05 and P < .01, respectively). The University of California, Los Angeles postoperative score was good to excellent in 7 patients at 6 months and in 8 patients at 12 months. Range of motion in forward flexion, abduction, internal rotation, and external rotation was significantly improved at both 6 and 12 months postoperatively (P < .05 and P < .01, respectively). Magnetic resonance imaging at 12 months showed healing in 90%; one patient had a definitive persistent tear. We found no adverse events associated with the patch, including the absence of fibrosis, mechanical symptoms, or visible subacromial adhesions.
DISCUSSION: The polycarbonate polyurethane patch was designed to support tissue in growth and enhance healing as shown by preclinical animal studies. Clinically, the patch is well tolerated and shows promising efficacy, with a 10% retear rate at the 12-month time point.
Authors:
Ivan Encalada-Diaz; Brian J Cole; John D Macgillivray; Michell Ruiz-Suarez; James S Kercher; Nicole A Friel; Fernando Valero-Gonzalez
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-11-24
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  20     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-17     Completed Date:  2011-12-13     Revised Date:  2014-01-10    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  788-94     Citation Subset:  IM    
Copyright Information:
Published by Mosby, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroscopy
Female
Follow-Up Studies
Humans
Middle Aged
Polycarboxylate Cement*
Polyurethanes*
Range of Motion, Articular
Reconstructive Surgical Procedures / methods*
Rotator Cuff / injuries,  surgery*
Rupture
Shoulder / injuries*,  surgery
Suture Techniques / instrumentation*
Tendon Injuries / physiopathology,  surgery*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
T32 AR052272/AR/NIAMS NIH HHS; T32 AR052272/AR/NIAMS NIH HHS
Chemical
Reg. No./Substance:
0/Polycarboxylate Cement; 0/Polyurethanes; 25766-59-0/polycarbonate
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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