Rotator cuff repair with biological graft augmentation causes adverse tissue outcomes.
Background and purpose — Biological patches can be used to augment rotator cuff tendon repair in an attempt to improve healing and reduce rates of re-rupture. However, little is known about the in vivo tissue response to these patches. We assessed native rotator cuff tissue response after surgical r...
| Publicado en: | Acta Orthopaedica Vol. 91; no. 6; pp. 782 - 789 |
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| Autores principales: | , , , , , , , |
| Formato: | clinical trial pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Dec2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148075921&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148075921 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Dec2020 vid: 91 iid: 6 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 148075921 145565438 148075921 148075921 10.1080/17453674.2020.1793613 148075921 ppf: 782 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Rotator cuff repair with biological graft augmentation causes adverse tissue outcomes. aug: au: Rashid, Mustafa S Smith, Richard D J Nagra, Navraj Wheway, Kim Watkins, Bridget Snelling, Sarah Dakin, Stephanie G Carr, Andrew J affil: Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, Oxford, UK sug: subj: Rotator Cuff Injuries Surgery Grafts Utilization Tissue Pathology Extracellular Space Treatment Outcomes Human Ultrasonography Intraoperative Period Biopsy Histology Immunochemistry Comparative Studies Clinical Trials Gene Expression Immunologic Factors ab: Background and purpose — Biological patches can be used to augment rotator cuff tendon repair in an attempt to improve healing and reduce rates of re-rupture. However, little is known about the in vivo tissue response to these patches. We assessed native rotator cuff tissue response after surgical repair and augmentation with 2 commercially available extracellular matrix (ECM) patches. Patients and methods — Patients underwent a rotator cuff repair augmented with either GraftJacket (Wright Medical), Permacol (Zimmer Biomet), or no patch (Control), applied using an onlay technique. A sample of supraspinatus tendon was collected intraoperatively and 4 weeks post-surgery, using ultrasound-guided biopsy. Histology and immunohistochemistry were performed on all samples. Results — The Permacol group (n = 3) and GraftJacket group (n = 4) demonstrated some changes in native tendon ECM compared with the control group (n = 3). Significant disruption of the extracellular matrix of the repaired native supraspinatus, underlying both patches, was observed. The patches did not generally increase cellularity, foreign body giant cell count, or vascularity compared to the control group. 1 patient in the Permacol group had an adverse tissue immune response characterized by extensive infiltration of IRF5+, CD68+, and CD206+ cells, suggesting involvement of macrophages with a pro-inflammatory phenotype. No significant differences in protein expression of CD4, CD45, CD68, CD206, BMP7, IRF5, TGFß, and PDPN were observed among the groups. Interpretation — Histological and immunohistochemical analysis of native tendon tissue after patch augmentation in rotator cuff repair raises some concerns about a lack of benefit and potential for harm from these materials. pubtype: Academic Journal doctype: clinical trial pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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