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Low retear rate found with absorbable biologic scaffold-reinforced rotator cuff repair
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ORLANDO, Fla. — Among patients who underwent arthroscopic rotator cuff repair reinforced with an absorbable biologic scaffold for treatment of full-thickness tears, researchers observed a low retear rate, along with improved function and clinical outcome scores.
“Arthroscopic rotator cuff repair with BioFiber (Tornier) augmentation demonstrates excellent clinical outcomes. Overall, full-thickness retear rate was very low at 4.6%. This is a technically manageable procedure with a limited learning curve and adding minimal time in the OR,” Scott E. Barbash, MD, said during his presentation at the American Orthopaedic Society for Sports Medicine. “Consider this in patients with increased risk for poor healing due to age, tear size, tissue quality or prior failed repair.”
Barbash and colleagues studied 50 patients who had arthroscopic rotator cuff repair with augmentation and 6 months of follow-up. Of these patients, six completed 1 year of follow-up. Barbash noted 12% of patients had previous cuff surgery. In addition, many patients underwent concomitant procedures. Repair constructs were based on tear size, geometry and surgeons’ discretion.
“The most common was a double-row suture type technique, with the large 25-mm patch being overlaid on the rotator cuff tear, but smaller patches were also used at each individual suture site,” Barbash said. “All of the tears involved the supraspinatus, and 42 involved the infraspinatus. The average tear size was 2.5 cm AP [anteroposterior] diameter, and average retraction was 1.7 cm.”
Augmented repair was performed in all supraspinatus tears, 63% of the infraspinatus tears and none of the subscapular tears. The surgical time for BioFiber placement was 17 minutes.
The researchers observed improvements in VAS pain and strength scores, as well as functional scores using the Constant-Murley and Western Ontario Rotator Cuff indexes, at 6 months and 12 months.
A musculoskeletal radiologist performed ultrasound to test the repair integrity for all patients at 6 months, which showed 45 intact repairs, two full-thickness recurrent tears and three partial-thickness attenuations with bridging tissue. An ultrasound evaluation of 46 patients at 12 months revealed 39 intact repairs, two full-thickness recurrent tears and five partial-thickness attenuations.
“Four adverse events were reported. None were felt to be a direct result of the repair or augmentation,” Barbash said. “Overall, our rate of success for arthroscopic rotator cuff repair with BioFiber augmentation at 12 months using full thickness retear as failure was 95.4%, which compared favorably with other studies that had scaffolds.”
According to Barbash, BioFiber augmentation demonstrated a favorable safety profile overall. – by Gina Brockenbrough, MA
Reference:
Barbash S, et al. Paper #44. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-12, 2015; Orlando, Fla.
Disclosure: Orthopedics Today was unable to determine whether Barbash has any relevant financial disclosures. Tornier, the makers of BioFiber, sponsored this study.