Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Feb 2015
Efficacy of interscalene block combined with multimodal pain control for postoperative analgesia after rotator cuff repair.
The aim of the study reported here was to compare the efficacy and safety of postoperative analgesia provided by interscalene block with multimodal pain control (IB-MPC) versus that provided by multimodal pain control (MPC) alone after arthroscopic rotator cuff repair. ⋯ Prospective Comparative Study, Prognosis Study, Level II.
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Knee Surg Sports Traumatol Arthrosc · Feb 2015
Outcome of distal clavicle resection in patients with acromioclavicular joint osteoarthritis and full-thickness rotator cuff tear.
The purpose of this study was to examine the impact of distal clavicle resection (DCR) on subjective and objective outcome measures in patients with acromioclavicular (AC) joint osteoarthritis (OA) and rotator cuff tear. ⋯ Retrospective outcome study, Level II.
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Knee Surg Sports Traumatol Arthrosc · Feb 2015
Randomized Controlled TrialTenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial.
Tenotomy and tenodesis are both effective for the treatment of long head biceps lesions. The aim of this study was to compare the clinical outcomes of the two procedures in patients older than 55 years of age affected by reparable rotator cuff tears with concomitant long head biceps pathologies. ⋯ Therapeutic studies, Level I.
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Knee Surg Sports Traumatol Arthrosc · Feb 2015
ReviewAdvances in biology and mechanics of rotator cuff repair.
High initial fixation strength, mechanical stability and biological healing of the tendon-to-bone interface are the main goals after rotator cuff repair surgery. Advances in the understanding of rotator cuff biology and biomechanics as well as improvements in surgical techniques have led to the development of new strategies that may allow a tendon-to-bone interface healing process, rather than the formation of a fibrovascular scar tissue. Although single-row repair remains the most cost-effective technique to address a rotator cuff tear, some biological intervention has been recently introduced to improve tissue healing and clinical outcome of rotator cuff repair. Animal models are critical to ensure safety and efficacy of new treatment strategies; however, although rat shoulders as well as sheep and goats are considered the most appropriate models for studying rotator cuff pathology, no one of them can fully reproduce the human condition. Emerging therapies involve growth factors, stem cells and tissue engineering. Experimental application of growth factors and platelet-rich plasma demonstrated promising results, but has not yet been transferred into standardized clinical practice. Although preclinical animal studies showed promising results on the efficacy of enhanced biological approaches, application of these techniques in human rotator cuff repairs is still very limited. Randomized controlled clinical trials and post-marketing surveillance are needed to clearly prove the clinical efficacy and define proper indications for the use of combined biological approaches. The following review article outlines the state of the art of rotator cuff repair and the use of growth factors, scaffolds and stem cells therapy, providing future directions to improve tendon healing after rotator cuff repair. ⋯ Expert opinion, Level V.