Clinical Outcomes following Biologically Enhanced Demineralized Bone Matrix Augmentation of Complex Rotator Cuff Repair.
Ian J WellingtonLukas N MuenchBenjamin C HawthorneColin L UyekiChristopher L AntonacciMary Beth McCarthyJohn P ConnorsCameron KiaAugustus D MazzoccaDaniel P BertholdPublished in: Journal of clinical medicine (2022)
Complex rotator cuff tears provide a significant challenge for treating surgeons, given their high failure rate following repair and the associated morbidity. The purpose of this study is to evaluate the clinical outcomes of patients who underwent biologically enhanced demineralized bone matrix augmentation of rotator cuff repairs. Twenty patients with complex rotator cuff tears underwent arthroscopic rotator cuff repair by a single surgeon with demineralized bone matrix (DBM) augmentation that was biologically enhanced with platelet-rich plasma and concentrated bone marrow aspirate. Post-operative MRI was used to determine surgical success. Patient reported outcome measures and range of motion data were collected pre-operatively and at the final post-operative visit for each patient. Ten patients (50%) with DBM augmentation of their arthroscopic rotator cuff repair were deemed non-failures. The failure group had less improvement of visual analogue pain scale ( p = 0.017), Simple Shoulder Test ( p = 0.032), Single Assessment Numerical Evaluation ( p = 0.006) and abduction ( p = 0.046). There was no difference between the groups for change in American Shoulder and Elbow Society score ( p = 0.096), Constant-Murley score ( p = 0.086), forward elevation ( p = 0.191) or external rotation ( p = 0.333). The present study found that 50% of patients who underwent biologically enhanced DBM augmentation of their rotator cuff repair demonstrated MRI-determined failure of supraspinatus healing.
Keyphrases
- rotator cuff
- soft tissue
- end stage renal disease
- patient reported
- bone marrow
- chronic kidney disease
- ejection fraction
- newly diagnosed
- platelet rich plasma
- bone mineral density
- magnetic resonance imaging
- peritoneal dialysis
- prognostic factors
- computed tomography
- chronic pain
- mesenchymal stem cells
- case report
- artificial intelligence
- deep learning
- pain management
- patient reported outcomes
- postmenopausal women