Sunday, June 14, 2015

Rotator cuff repair - are graft patches of value to the patient?

Treatment of massive and recurrent rotator cuff tears augmented with a poly-l-lactide graft, a preliminary study.

These authors reported on 16 patients with repair of  two tendon tears augmented with a  poly-l-lactide synthetic polymer. Two patients required the patch to bridge defects, and 1 patient retore after a motor vehicle accident and had revision surgery at another institution. The 13 remaining patients were retrospectively evaluated from 1.2 to 1.7 years (average, 1.5 years) after surgery.  Five patients (38%) had an intact rotator cuff according to MRI at the time of follow-up. The remaining patients (62%) had full-thickness tears. 

The authors do not indicate that the clinical results correlated with the integrity of the repair.

A prior related post can be found here.

The authors do not present data on the incremental cost of this device - either in terms of the cost of the device itself or the time necessary to implant it. Many previous reports of cuff repair have presented improvements in clinical measures even though the surgery failed to achieve integrity of the rotator cuff repair. This study does not demonstrate that this graft has value to the patient.


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