A multimodal approach to rotator cuff tears: pain, satisfaction and functional outcomes of rotator cuff repair with bovine bioinductive patch
ESSKA Academy. Briggs K. 11/08/19; 285251; epESA-31 Topic: A3 - Rotator cuff repair of full thickness tear (arthroscopic)
Karen Briggs
Karen Briggs
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Introduction: Recovery following rotator cuff repair can be a prolonged process plagued with high failure rates after rotator cuff repair, occurring in twenty percent to ninety-four percent of patients at one to two-year follow-up with eighty percent of these failures occurring within three months of surgical intervention. Bovine collagen bioinductive patches have been shown to induce tissue repair and provide load sharing across the repair site. We investigated pain, satisfaction, and functional outcomes in patients that underwent rotator cuff repair with the bovine bioinductive patch augmentation.
Methods: Twelve patients with either a partial (N=9) or full thickness (N=3) rotator cuff tear underwent arthroscopic rotator cuff repair plus bovine bioinductive patch augmentation (4 females/8 males, 62.3±14 years old, BMI 32.3±13.7) were included. Rotator cuff repair plus bovine bioinductive patch augmentation (REGENETEN, Smith & Nephew, Massachusetts, USA) was performed between 2015-2018 by a single surgeon. All patients followed a conservative rehabilitation program and were administered NSAIDs for 3 months postoperatively. Pre- and postoperative physical exam included manual muscle strength and shoulder flexion, external rotation at side and at 90° abduction, internal rotation ROM. Postoperative pain, function and patient satisfaction were measured using an 11-point VAS score (range 0-10), ASES, and DASH. ANOVA was used to assess differences before and after surgery (p< 0.05).
Results: Average follow-up was 20±6 months. Shoulder VAS pain score (0.56±0.88) and patient satisfaction (8.5±0.55) significantly improved postoperatively. Shoulder flexion (p=0.0063), ER at 90° abduction (p=0.046) and internal rotation (p=0.0235) ROM also demonstrated significant improvements with notable improvement by 3 months. Postoperative DASH score was 10.4±12.8, SF-12 physical score 52.8±5 and mental score 54.2±5.6. All patients returned to previous activities by 12 weeks. There were no complications or clinical failures at 20 months.
Discussion: Utilization of a bovine bioinductive patch for partial or for full thickness rotator cuff tear appears to aid in the healing and recovery after rotator cuff repair and the utilization of NSAIDs does not appear to impede healing. We recommend the bioinductive patch plus NSAIDs as an alternative to narcotics to allow patients to return to ADLs and work within 3-4 days and full return to activities within 3-6 months.
Introduction: Recovery following rotator cuff repair can be a prolonged process plagued with high failure rates after rotator cuff repair, occurring in twenty percent to ninety-four percent of patients at one to two-year follow-up with eighty percent of these failures occurring within three months of surgical intervention. Bovine collagen bioinductive patches have been shown to induce tissue repair and provide load sharing across the repair site. We investigated pain, satisfaction, and functional outcomes in patients that underwent rotator cuff repair with the bovine bioinductive patch augmentation.
Methods: Twelve patients with either a partial (N=9) or full thickness (N=3) rotator cuff tear underwent arthroscopic rotator cuff repair plus bovine bioinductive patch augmentation (4 females/8 males, 62.3±14 years old, BMI 32.3±13.7) were included. Rotator cuff repair plus bovine bioinductive patch augmentation (REGENETEN, Smith & Nephew, Massachusetts, USA) was performed between 2015-2018 by a single surgeon. All patients followed a conservative rehabilitation program and were administered NSAIDs for 3 months postoperatively. Pre- and postoperative physical exam included manual muscle strength and shoulder flexion, external rotation at side and at 90° abduction, internal rotation ROM. Postoperative pain, function and patient satisfaction were measured using an 11-point VAS score (range 0-10), ASES, and DASH. ANOVA was used to assess differences before and after surgery (p< 0.05).
Results: Average follow-up was 20±6 months. Shoulder VAS pain score (0.56±0.88) and patient satisfaction (8.5±0.55) significantly improved postoperatively. Shoulder flexion (p=0.0063), ER at 90° abduction (p=0.046) and internal rotation (p=0.0235) ROM also demonstrated significant improvements with notable improvement by 3 months. Postoperative DASH score was 10.4±12.8, SF-12 physical score 52.8±5 and mental score 54.2±5.6. All patients returned to previous activities by 12 weeks. There were no complications or clinical failures at 20 months.
Discussion: Utilization of a bovine bioinductive patch for partial or for full thickness rotator cuff tear appears to aid in the healing and recovery after rotator cuff repair and the utilization of NSAIDs does not appear to impede healing. We recommend the bioinductive patch plus NSAIDs as an alternative to narcotics to allow patients to return to ADLs and work within 3-4 days and full return to activities within 3-6 months.
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