Sunday, March 2, 2014

Not much support for the use of biologics in rotator cuff repair.

Application of biologics in the treatment of the rotator cuff, meniscus, cartilage, and osteoarthritis.

Abstract: "Advances in our knowledge of cell signaling and biology have led to the development of products that may guide the healing/regenerative process. Therapies are emerging that involve growth factors, blood-derived products, marrow-derived products, and stem cells. Animal studies suggest that genetic modification of stem cells will be necessary; studies of cartilage and meniscus regeneration indicate that immature cells are effective and that scaffolds are not always necessary. Current preclinical animal and clinical human data and regulatory requirements are important to understand in light of public interest in these products."

With respect to rotator cuff repair, however, the authors conclude that 'synthesis of all the studies illustrates that there is no clear advantage to using PRP (platelet rich plasma) as a surgical adjunct to rotator cuff repair'. A similar statement was made about mesenchymal stem cells.

Comment: While there is no question that platelets, growth factors and stem cells are part of the body's response to injury and healing process, there are many complexities in trying to improve on nature's finely tuned healing response.

As pointed out the Rotator Cuff Tear Book, we consider rotator cuff repair when tendon of good quality can be brought to bone of good quality without undue tension on the repair. We then intentionally create a injury to the bone in the form of trough into which the tendon is secured. By creating this trough, we cause local bleeding and start the response to injury with the natural influx of platelets, growth factors, and stem cells.

Consultation for those who live a distance away from Seattle.

Check out the new Shoulder Arthritis Book - click here.

Click here to see the new Rotator Cuff Book

To see the topics covered in this Blog, click here

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'