Biologic and pharmacologic augmentation of rotator cuff repairs

Sara L. Edwards*, T. Sean Lynch, Matthew D. Saltzman, Michael A. Terry, Gordon W. Nuber

*Corresponding author for this work

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

As rotator cuff repair techniques have improved, failure of the tendon to heal to the proximal humerus is less likely to occur from weak tendon-to-bone fixation. More likely causes of failure include biologic factors such as intrinsic tendon degeneration, fatty atrophy, fatty infiltration of muscle, and lack of vascularity of the tendons. High failure rates have led to the investigation of biologic augmentation to potentially enhance the healing response. Histologic studies have shown that restoration of the rotator cuff footprint during repair can help reestablish the enthesis. In animal models, growth factors and their delivery scaffolds as well as tissue engineering have shown promise in decreasing scar tissue while maintaining biomechanical strength. Platelet-rich plasma may be a safe adjuvant to rotator cuff repair, but it has not been shown to improve healing or function. Many of these strategies need to be further defined to permit understanding of, and to optimize, the biologic environment; in addition, techniques need to be refined for clinical use.

Original languageEnglish (US)
Pages (from-to)583-589
Number of pages7
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume19
Issue number10
DOIs
StatePublished - Oct 2011

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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