Sunday, September 22, 2019

Rotator cuff repair - is a porcine dermal patch of value to the patient?

Prospective randomized controlled trial for patch augmentation in rotator cuff repair: 24-month outcomes

These authors used a double-blinded randomized control trial of 92 patients to evaluate the anatomic integrity of rotator cuff repair performed by medialized single row and augmented by a porcine dermal patch, in comparison with a nonaugmented group.

The patch group showed a healing by MRI of 97.6% compared with 59.5% for the standard repair group. 

However, there was no significant difference for most of the outcome measures of patient comfort and function.

Comment:
It is of note that the patient reported outcomes by Simple Shoulder Test were outstanding for both the non-patch and the patch groups: preoperative scores of 3 to postoperative scores of 10, representing an improvement of over 80% of the maximum possible improvement.

This article did not compare the MRI results with the clinical results - this would seem to be important for determining the clinical importance of the MRI outcomes.

The article did not report on the incremental operative time or cost attributable to the use of the porcine graft.

At this point, therefore the value to the patient of the porcine graft remains undetermined.

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