Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair

Version 1 : Received: 23 July 2023 / Approved: 24 July 2023 / Online: 24 July 2023 (07:07:21 CEST)

A peer-reviewed article of this Preprint also exists.

Colosio, A.; Bergomi, A.; Pratobevera, A.; Paderno, M.; Saccomanno, M.F.; Milano, G. Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair. J. Clin. Med. 2023, 12, 5694. Colosio, A.; Bergomi, A.; Pratobevera, A.; Paderno, M.; Saccomanno, M.F.; Milano, G. Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair. J. Clin. Med. 2023, 12, 5694.

Abstract

Background: Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. Methods: A retrospective comparative study was conducted on patients that underwent ARRCR with minimum two-years follow-up. Patients in the augmentation group underwent ARRCR combined with microfractures, collagen patch graft, and postoperative subacromial injections of platelet concentrate. A standard rotator cuff repair was performed in the control group. Primary outcome: Constant Murley score (CMS). Secondary outcomes: disease-specific health-related quality of life by using the Disabilities of the Arm, Shoulder and Hand (DASH) score; assessment of tendon integrity with magnetic resonance at least six months after surgery. Significance was set at p < 0.05. Results: Forty patients were included. Mean follow-up was 36.2 + 8.7 months. The mean CMS was greater in the augmentation group (p = 0.022). No differences could be found for DASH score. Healing failure rate was higher in the control group (p = 0.002). Conclusion: Biologic augmentation of ARRCR by combination of microfractures, collagen patch graft and subacromial injections of platelet concentrate is an effective strategy in improving tendon healing rate.

Keywords

rotator cuff; retears; revision; augmentation; platelet concentrate; patch graft

Subject

Medicine and Pharmacology, Orthopedics and Sports Medicine

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