Autologous dermal fibroblast injection may decrease rotator cuff retear risk
Key takeaways:
- Autologous dermal fibroblasts may decrease risk of rotator cuff retears after arthroscopic rotator cuff repair vs. repair alone.
- Both treatments showed similar and significant improvements in clinical outcomes.
An autologous dermal fibroblast injection into the bone-tendon interface after arthroscopic rotator cuff repair may promote tissue healing and reduce the rate of retears, according to published results.
However, results showed patients who received autologous dermal fibroblasts (ADFs) had similar improvements in clinical outcomes at 6-month and 1-year follow-ups compared with patients who received arthroscopic rotator cuff repair alone.
“Dermal fibroblasts exhibit multiple similarities to tendon cells, suggesting that they may be a promising cell source for tendon engineering,” Young Kyu Kim, MD, from the department of orthopedic surgery at Bundang Jesaeng Hospital in South Korea, and colleagues wrote in the study. “Unlike many types of cell-based therapy that require bone marrow, adipose-derived stem cells or tenocyte tissue with major defects for a biopsy, dermal fibroblasts can be obtained using a small-incision biopsy of the skin.”
Kim and colleagues performed a prospective, randomized controlled trial of 86 patients with full-thickness rotator cuff tears of larger than 2 cm who underwent arthroscopic rotator cuff repair with (n = 43) or without (n = 43) ADFs between January 2019 and April 2022.
“A skin biopsy from the buttock was performed to obtain ADFs, which were cultured for approximately 4 weeks before surgery,” Kim and colleagues wrote in the study.
At 6 months, 36 patients who received ADF and 37 patients who did not were available for follow-up. At 1 year, 33 patients in the ADF group and 32 patients in the arthroscopic rotator cuff repair alone group were available for follow-up.
Outcome measures included rotator cuff retear on MRI at 6-month follow-up, as well as American Shoulder and Elbow Surgeons score, Constant score and Simple Shoulder Test score at 6-month and 1-year follow-ups.
Overall, Kim and colleagues found the ADF group had a significantly decreased rate of rotator cuff retear (5.6%; n = 2) compared with the arthroscopic rotator cuff repair alone group (24.3%; n = 9) at 6 months.
Kim and colleagues found both groups had similar and significant improvements in ASES, Constant and Simple Shoulder Test scores from baseline to 1-year follow-up. In addition, they found no significant differences in active forward flexion, external rotation with the arm at 90° of abduction and internal rotation between the groups at 6 months and 1 year.
“These findings show the substantial advantages of using biological supplements such as ADFs to increase the rate of rotator cuff healing in the near future,” Kim and colleagues concluded.
Collapse
Read more about