Bioinductive implant may be safe, effective in partial-thickness rotator cuff tears
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NASHVILLE, Tenn. — Use of a bioinductive, bovine collagen implant may be safe and effective in the treatment of partial-thickness rotator cuff tears, according to a presenter.
Brandon D. Bushnell, MD, MBA, of Harbin Clinic Orthopedics, and colleagues retrospectively reviewed data for 272 patients with partial-thickness rotator cuff tears who received a bioinductive, bovine collagen implant (Regeneten, Smith & Nephew) from April 2016 to December 2018 across 19 institutions in the United States. Researchers assessed patient-reported outcome scores preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months and 1 year postoperatively. Researchers also assessed time in physical therapy, time in a sling, additional surgery and times to return to work, sport and driving.
Overall, 83.4% of patients had 1-year data available for inclusion. In his presentation at the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Combined Meeting, Bushnell noted a statistically significant improvement in patient-reported outcome scores at 1 year postoperatively. All patient-reported outcome scores also met or exceeded the minimal clinically important difference at 1 year, according to Bushnell. He added patients underwent additional surgery at a rate of 4.85%, with adhesive capsulitis being the main cause for additional surgery, followed by clinically significant bursitis, retear/failure to heal and dislodged graft.
Bushnell noted days in physical therapy and times to return to work, sport and driving compared favorably with historically reported data. Patients with no prior shoulder surgery had significantly superior scores for Western Ontario Rotator Cuff scores and for ASES pain, function and shoulder scores at 1 year postoperatively, according to Bushnell. He also noted no significant differences between patients who did and those who did not undergo biceps surgery at 1 year postoperatively.
“We looked at tenotomy, tenodesis and then leaving [the biceps] alone, and, essentially, at least in this group, it did not matter,” Bushnell told Healio Orthopedics. “So, whether or not you [performed surgery on] the biceps was not indicative of success across this group.”
In a subgroup analysis, patients who underwent isolated bioinductive repair alone had significantly better ASES Shoulder, SANE and Western Ontario Rotator Cuff scores at 2 weeks and 6 weeks compared with patients who underwent takedown and repair with implant supplementation, according to Bushnell. However, he added the two groups had no significant differences at 1 year postoperatively.
“What we saw was that at 1 year, those groups were equal – that they both did well,” Bushnell said. “But early on, at the 2-week mark and at the 6-week mark, the [isolated bioinductive repair] IBR group did better.”
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Bushnell BD, et al. Paper 18. Presented at: American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting; July 7-11, 2021; Nashville, Tennessee.
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