scholarly journals Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Nicola Maffulli ◽  
Umile Giuseppe Longo ◽  
Mattia Loppini ◽  
Alessandra Berton ◽  
Filippo Spiezia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tissue Engineering ◽  
Stem Cells ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Tissue Engineering Application ◽  
Significant Difference ◽  
Cuff Repair

The purpose of this systematic review was to address the treatment of rotator cuff tears by applying tissue engineering approaches to improve tendon healing, specifically platelet rich plasma (PRP) augmentation, stem cells, and scaffolds. Our systematic search was performed using the combination of the following terms: “rotator cuff”, “shoulder”, “PRP”, “platelet rich plasma”, “stemcells”, “scaffold”, “growth factors”, and “tissue engineering”. No level I or II studies were found on the use of scaffolds and stem cells for rotator cuff repair. Three studies compared rotator cuff repair with or without PRP augmentation. All authors performed arthroscopic rotator cuff repair with different techniques of suture anchor fixation and different PRP augmentation. The three studies found no difference in clinical rating scales and functional outcomes between PRP and control groups. Only one study showed clinical statistically significant difference between the two groups at the 3-month followup. Any statistically significant difference in the rates of tendon rerupture between the control group and the PRP group was found using the magnetic resonance imaging. The current literature on tissue engineering application for rotator cuff repair is scanty. Comparative studies included in this review suggest that PRP augmented repair of a rotator cuff does not yield improved functional and clinical outcome compared with non-augmented repair at a medium and long-term followup.

scholarly journals Stem cell application in rotator cuff repair: Interposition stem cell sheet versus overlaid stem cell sheet

2020 ◽  
Author(s):  
Jae hee Choi ◽  
Michael Seungcheol Kang ◽  
Myung Jin Shin ◽  
Dong Min Kim ◽  
Yu Na Lee ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Surgical Repair ◽  
Cell Sheet ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Cell Sheets ◽  
Cuff Repair

Abstract Background Stem cells are an effective method of biologic healing and can be used to enhance the natural enthesis of the tendon-to-bone junction in rotator cuff repair. The purpose of this study was to investigate if the application of engineered stem cell sheets using adipose-derived cells (ADSCs) was effective in regeneration of natural enthesis and if there was a difference in the result of repair depending on the applied location Methods A chronic rotator cuff tear model was induced for 2 weeks, and cell sheets made using ADSCs isolated from rats were transplanted into the tendon-to-bone junction during surgical repair. Depending on the transplant location of the cell sheet, the difference in rotator cuff healing level between the overlaid group and the interposition group was compared to the surgical repair only group. The samples were obtained based on the tendon-to-bone junction and analysis of gross morphology, histology staining, and biomechanical analysis were performed. Results The differentiation potentials of ADSCs as stem cells were confirmed, as was the potential for tenogenic differentiation by growth factors. ADSCs were prepared as a sheet form to maintain the shape at the target site and to be easily attached. GFP-expressing ADSCs were proliferated in vivo and observed at the transplantation site. The overall healing level was better in the cell sheet transplanted group than in the control group that surgical repair only. Additionally, differences in healing level were shown depending on the cell sheet location by morphological, histological, and biomechanical perspectives. Histological results showed that the interposition transplantation group (1.75 ± 0.43, P = 0.004) showed better fibrocartilage formation and collagen orientation at the junction than the overlaid transplantation group (0.86 ± 0.83). Conclusion In the chronic rotator cuff repair model, the engineered stem cell sheets enhanced the regeneration of the tendon-to-bone junction. This regeneration was more effective when the stem cell sheet was interpositioned at the tendon-to-bone interface. Trial registration: Not applicable

scholarly journals Current Biological Strategies to Enhance Surgical Treatment for Rotator Cuff Repair

2021 ◽  
Vol 9 ◽  
Author(s):  
Cheng Zhang ◽  
Jun Wu ◽  
Xiang Li ◽  
Zejin Wang ◽  
Weijia William Lu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Growth Factors ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Cuff Tear ◽  
Research Perspectives ◽  
Cuff Repair

Rotator cuff tear is one of the most common shoulder problems encountered by orthopedic surgeons. Due to the slow healing process and high retear rate, rotator cuff tear has distressed millions of people all around the world every year, especially for the elderly and active athletes. This disease significantly impairs patients’ motor ability and reduces their quality of life. Besides conservative treatment, open and arthroscopic surgery contributes a lot to accelerate the healing process of rotator cuff tear. Currently, there are many emerging novel treatment methods to promote rotator cuff repair. A variety of biological stimulus has been utilized in clinical practice. Among them, platelet-rich plasma, growth factors, stem cells, and exosomes are the most popular biologics in laboratory research and clinical trials. This review will focus on the biologics of bioaugmentation methods for rotator cuff repair and tendon healing, including platelet-rich plasma, growth factors, exosomes and stem cells, etc. Relevant studies are summarized in this review and future research perspectives are introduced.

scholarly journals Systematic Review of Literature on the Efficiency of Using PRP in Arthroscopic Rotator Cuff Repair

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T M Samy ◽  
A H Khater ◽  
A K M Ahmed
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Bone Repair ◽  
Platelet Rich Plasma ◽  
Tendon Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Rotator cuff tears are one of the most common shoulder problems and the incidence of this condition is increasing along with an aging population. Despite satisfactory results for rotator cuff repair the quality and speed of healing remain problematic. Several studies have demonstrated that native tendon-bone insertions were not restored after tendon to bone repair. Healing of repaired tendons occurred via fibrous scar tissue formation rather than via the regeneration of a histologically normal insertion, and thus repaired tendons have inferior mechanical properties and are more susceptible to retear. Presumably, this is the most significant reason that account for tendon repair failure. Despite recent biomechanical advances in fixation, rates of retear are still high. Tendons consume little energy, and as a consequence healing is slow after injury. Increasing the speed of healing would allow earlier return to work, sport, and activities of daily living, which would be helpful for both the elite athlete and general public. Platelet rich plasma was first popularized in maxillofacial and plastic surgery, but now is thought to enhance and accelerate the repair and regeneration of a variety of tissues, such as bone, cartilage, tendon, ligament, and muscle. This systematic review reporting the effect of PRP after arthroscopic rotator cuff repair.

scholarly journals Platelet Rich Plasma in Arthroscopic Rotator Cuff Repair: Clinical and Radiological Results of A Prospective RCT Study at 10-Year Follow-Up

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0024
Author(s):  
Pietro Randelli ◽  
Carlo Alberto Stoppani ◽  
Elisabetta Nocerino ◽  
Alessandra Menon ◽  
Riccardo Compagnoni
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Platelet Rich Plasma ◽  
Arthroscopic Rotator Cuff Repair ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Objectives: Despite the technical advancement in arthroscopic rotator cuff repair, inadequate healing or retear of the repaired rotator cuff frequently occurs. The use of biological factors in the surgical treatment has been proved to be effective to enhance tendon healing in the post-operative period. The aim of the study is to compare clinical and radiological outcomes of arthroscopic rotator cuff repair with or without the addition of platelet-rich plasma (PRP) at 10-year follow-up. Methods: Of 53 patients recruited in the study, and randomly divided into two groups (PRP=26; control=27), 38 were re-evaluated at least 10 years after the index procedure. The clinical evaluation was carried out through: University of California at Los Angeles (UCLA) Shoulder Score, Visual Analogue Scale (VAS), Simple Shoulder Test (SST), Constant-Murley Score (CMS), Single Assessment Numerical Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES) and isometric strength in abduction and external rotation. Musculoskeletal ultrasound had been used to evaluate the integrity of the repaired cuff. Results: A number of 38 (71%) patients (PRP=17; control=21) with a median age of 71 [64.75-76.50] years have been evaluated. Satisfaction at follow-up is high (90%), without statistically significant difference between the two groups. We report good and excellent clinical results in both groups (PRP vs control): CMS (81.62 [72.47-85.75] vs 77.97 [69.52-82.55] points), UCLA (34 [29.00-35.00] vs 33 [29.00-35.00] points), VAS (0.34 [0.00-1.85] vs 0.70 [0.00-2.45] cm), ASES (100.00 [94.17-100.00] vs 93.33 [68.33-100.00] points), SANE (100 [80-100] vs 80 [70-90] points), SST (12.00 [11.00-12.00] vs 12.00 [9.00-12.00] points),shoulder abduction strength (3.92 ± 2.30 vs 3.20 [1.72-4.65] kg), shoulder external rotation strength (5.31 ± 2.77 vs 4.36 ± 2.05 kg). It was not possible to find a statistically significant difference for the variables analysed, except for few subjective variables (ASES, SANE). On average, 37% of the operated patients had a re-rupture at the ultrasound examination, with no significant difference between the two groups (p=1.00). Compared with the previous radiological control at the 2-year follow-up, new retears occurred in 6% of the patients that received PRP treatment, whereas in the control group the percentage raises to 14% (p=0.61). Conclusions: The clinical and radiological outcomes at the 10-year follow-up show a substantial uniformity of results between the two groups. The clinical differences that had been observed at 2-year follow-up disappeared at long term. A reduction in retear rate is observed at US evaluation in the PRP group at 10 years follow-up and this trend needs to be further analyzed. Patients’ satisfaction is still high 10 years after surgical treatment, in both groups.

The effect of perioperative platelet-rich plasma injections on postoperative failure rates following rotator cuff repair: a systematic review with meta-analysis

2020 ◽  
Vol 29 (5) ◽  
pp. 1059-1070
Author(s):  
Parker A. Cavendish ◽  
Joshua S. Everhart ◽  
Alex C. DiBartola ◽  
Alexander D. Eikenberry ◽  
Gregory L. Cvetanovich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Failure Rates ◽  
Cuff Repair

Does having a rotator cuff repair prior to reverse total shoulder arthroplasty influence the outcome?

2019 ◽  
Vol 101-B (1) ◽  
pp. 63-67 ◽  
Author(s):  
B. J. Erickson ◽  
D. Ling ◽  
A. Wong ◽  
J. J. Eno ◽  
J. S. Dines ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Rotator Cuff Repair ◽  
Matched Control ◽  
Reverse Shoulder Arthroplasty ◽  
Control Group ◽  
Study Group ◽  
Matched Control Group ◽  
Significant Difference ◽  
Cuff Repair

Aims The number of rotator cuff repairs that are undertaken is increasing. Reverse shoulder arthroplasty (RSA) is the procedure of choice for patients with rotator cuff arthropathy. We sought to determine whether patients who underwent rotator cuff repair and subsequent RSA had different outcomes compared with a matched control group who underwent RSA without a previous rotator cuff repair. Patients and Methods All patients with a history of rotator cuff repair who underwent RSA between 2000 and 2015 with a minimum follow-up of two years were eligible for inclusion as the study group. Outcomes, including the American Shoulder and Elbow Surgeons (ASES) scores, were compared with a matched control group of patients who underwent RSA without having previously undergone rotator cuff repair. Results The study group included 45 patients. Their mean age was 69 years (sd 8.6) and 27 patients (60%) were women. The mean ASES score improved from 43.1 to 76.6 two years postoperatively, and to 66.9 five years postoperatively. There was no significant difference between the outcomes at two years in the two groups (all p ≥ 0.05), although there was significantly more improvement in ASES scores in the control group (44.5 vs 33.4; p = 0.01). However, there was no significant difference between ASES scores at two and five years when baseline ASES scores were matched in the two groups (p = 0.42 at two years; p = 0.35 at five years). Conclusion Significant improvements in ASES scores were seen following RSA in patients who had previously undergone rotator cuff repair. They had higher baseline ASES scores than those who had not previously undergone this surgery. However, there was no significant difference in outcomes between the two groups, two years postoperatively. Previous rotator cuff repair does not appear to affect the early outcome after RSA adversely.

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