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CC BY-NC-ND 4.0 · Joints 2018; 06(03): 135-140
DOI: 10.1055/s-0038-1676106
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Porcine Dermal Xenograft as Augmentation in the Treatment of Large Rotator Cuff Tears: Clinical and Magnetic Resonance Results at 2-Year Follow-Up

Alessandro Castagna
1   Center for Shoulder and Elbow Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
,
Eugenio Cesari
2   Shoulder Surgery Unit, Humanitas Gavazzeni Institute, Bergamo, Italy
,
Berardo Di Matteo
3   Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
4   Humanitas Clinical and Research Center, Rozzano, Milan, Italy
,
Marcello Osimani
5   Department of Radiological Sciences, University of Rome “Sapienza,” ICOT, Latina, Italy
,
Raffaele Garofalo
6   Upper Limb Unit, F. Miulli Hospital, Acquaviva delle Fonti, Bari, Italy
,
Elizaveta Kon
3   Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
4   Humanitas Clinical and Research Center, Rozzano, Milan, Italy
,
Maurilio Marcacci
3   Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
4   Humanitas Clinical and Research Center, Rozzano, Milan, Italy
,
Claudio Chillemi
7   Department of Othopaedics and Traumatology – Istituto Chirurgico Ortopedico Traumatologico (ICOT), Latina, Italy
› Author Affiliations Funding None.
Further Information

Publication History

16 May 2018

20 October 2018

Publication Date:
12 December 2018 (online)

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Abstract

Purpose The aim of the present retrospective study is to describe the results obtained at 2-year follow-up by using a porcine dermis-derived collagen membrane implanted as augmentation to treat large rotator cuff tears.

Methods Thirty-five patients in total were included according to the following criteria: large or massive rotator cuff tear, confirmed during surgery, measuring between 3 and 5 cm in width and stage 1 to 2 fatty infiltration documented at magnetic resonance imaging (MRI). Patients underwent arthroscopic repair of the cuff augmented by the implantation of a porcine dermal collagen membrane. Patients were evaluated up to 24 months after surgery by the Constant score and MRI imaging to assess functional outcomes and re-tear rate. The results obtained were compared to those of a matched cohort of 35 patients operated by arthroscopic repair alone by the same surgical team.

Results The application of the porcine membrane proved to be safe without scaffold-related adverse events documented. A statistically significant difference in the Constant score in favor of the treatment group was documented at the final evaluation (p = 0.036). Furthermore, a subgroup analysis revealed that patients treated by augmentation and presenting re-tear at MRI showed a significantly higher functional outcome compared with control patients with MRI evidence of re-tear (p = 0.0136).

Conclusion Arthroscopic repair augmented by porcine dermal xenograft for the treatment of chronic and retracted rotator cuff tears with low-grade fatty degeneration proved to be safe and also effective, with higher functional score compared with the arthroscopic repair alone.

Level of Evidence This is a Level III, retrospective cohort study.

Keywords

rotator cuff - massive tear - scaffold - dermal collagen membrane - augmentation

Note

All the data, due to privacy reasons, will be available upon motivated request to the corresponding author of the present article.


 

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