Collagen patch augmentation showed no added benefit after arthroscopic rotator cuff repair
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Key takeaways:
- Patients had improved functional and pain scores after arthroscopic repair of massive rotator cuff tears.
- However, no additional improvements in healing were seen with collagen patch augmentation.
Arthroscopic repair of massive rotator cuff tears improved active range of motion and patient-reported outcomes; however, no additional improvements in healing were seen with collagen patch augmentation, according to presented results.
At the International Congress on Shoulder and Elbow Surgery, Samer S. Hasan, MD, PhD, presented results from his study on early clinical and imaging results following repair of retracted massive rotator cuff tears with vs. without collagen patch augmentation.
Hasan and colleagues analyzed data from 24 patients (mean age of 60.8 years) who underwent arthroscopic tendon to bone repair of a massive rotator cuff tear that involved two or three tendons and exceeded 4 cm in length followed by collagen patch augmentation. They also analyzed data from a control group of 24 patients (mean age of 61.5 years) with matched tear sizes who underwent the same procedure without collagen patch augmentation.
Hasan and colleagues found active elevation improved from 110° to 149° in the collagen group and from 130° to 153° in the control group. Hasan noted both cohorts had similar improvements across all functional and pain scores with 90% of patients in the collagen group and 100% of patients in the control group achieving the minimal clinically important difference for American Shoulder and Elbow Surgeons scores and VAS pain scores.
“The observed improvement in active range of motion and patient-reported outcomes following repair of [massive rotator cuff tears] mRCTs should embolden surgeons to do their best arthroscopic repair, even for massive tears, as an alternative to salvage operations such as superior capsule reconstruction or reverse shoulder arthroplasty,” Hasan told Healio.
Hasan noted no additional benefit from collagen patch augmentation as 55% of the collagen group and 53% of the control group had intact repairs on postoperative MRIs.
“Our failure to demonstrate improved healing rates with collagen implant augmentation reminds us that even biologic interventions that have been shown to improve healing after repair of smaller tears, such as the collagen implant, have their limits and may not be as helpful for healing after repair of massive or recurrent tears,” he added.
“Tools that predict healing after repair, such as the rotator cuff healing index, can be used to guide patient selection for repair and use of adjuncts such as [a] collagen patch,” Hasan concluded.
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Hasan SS, et al. FP.12.06. Presented at: International Congress on Shoulder and Elbow Surgery; Sept. 5-8, 2023; Rome.
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