Extracellular patches act as augments during healing of rotator cuff repairs
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NASHVILLE, Tenn. — Surgeons have a lot to learn about how extracellular matrix patches work to heal rotator cuff tears and how the environment into which these will be placed impact patch performance, a presenter said, here.
To highlight the biology of how these patches work and the role of these patches in augmentation of rotator cuff repairs, Scott A. Rodeo, MD, discussed key factors that surgeons who plan to use these patches must consider during a lecture at the American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting.
“These implants have widely varying biologic and material properties,” he said, and one use is in an interpositional role “to bridge a gap if the tendon cannot be mobilized to bone.”
Patches can also be load-sharing materials when rigidly fixed to the tendon and bone. The patches “stress-protect” the rotator cuff repair, an approach that augments the biomechanics of the repair, Rodeo, who is an Orthopedics Today Editorial Board Member, said.
In the case of a native tendon that cannot be repaired, a patch might be placed on top of the tendon to load share, he said.
“Third, you use an augment,” according to Rodeo.
In this case, the patch “serves as a scaffold for tissue formation in or on, around the tendon and this application of the patch essentially serves as a scaffold to support cell migration, cell proliferation and ultimately, aids in synthesis,” he said.
However, Rodeo noted, it does not provide any real mechanical role.
Also, extracellular matrix patches can be placed at the tendon and bone interface, he said. Used in this way, the patch will “support tissue healing at that tendon-bone interface.”
“Our recommendation is to place the patch on the superior aspect of the tendon on top of the repair,” Rodeo said.
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