Advances in biology and mechanics of rotator cuff repair

Verfasser / Beitragende:
[Olaf Lorbach, Mike Baums, Tanja Kostuj, Stephan Pauly, Markus Scheibel, Andrew Carr, Nasim Zargar, Maristella Saccomanno, Giuseppe Milano]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/2(2015-02-01), 530-541
Format:
Artikel (online)
ID: 605460205
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024 7 0 |a 10.1007/s00167-014-3487-2  |2 doi 
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245 0 0 |a Advances in biology and mechanics of rotator cuff repair  |h [Elektronische Daten]  |c [Olaf Lorbach, Mike Baums, Tanja Kostuj, Stephan Pauly, Markus Scheibel, Andrew Carr, Nasim Zargar, Maristella Saccomanno, Giuseppe Milano] 
520 3 |a 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. Level of evidence Expert opinion, Level V. 
540 |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 
690 7 |a Rotator cuff  |2 nationallicence 
690 7 |a Biology  |2 nationallicence 
690 7 |a Biomechanics  |2 nationallicence 
690 7 |a Growth factors  |2 nationallicence 
690 7 |a Augmentation  |2 nationallicence 
690 7 |a Cell therapy  |2 nationallicence 
700 1 |a Lorbach  |D Olaf  |u Department of Orthopaedic Surgery, Saarland University, Homburg, Germany  |4 aut 
700 1 |a Baums  |D Mike  |u Department of Orthopaedic Surgery, University of Göttingen Medical Centre (UMG), Georg-August-University, Göttingen, Germany  |4 aut 
700 1 |a Kostuj  |D Tanja  |u Institute for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany  |4 aut 
700 1 |a Pauly  |D Stephan  |u Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany  |4 aut 
700 1 |a Scheibel  |D Markus  |u Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany  |4 aut 
700 1 |a Carr  |D Andrew  |u Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK  |4 aut 
700 1 |a Zargar  |D Nasim  |u Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK  |4 aut 
700 1 |a Saccomanno  |D Maristella  |u Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy  |4 aut 
700 1 |a Milano  |D Giuseppe  |u Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy  |4 aut 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lorbach  |D Olaf  |u Department of Orthopaedic Surgery, Saarland University, Homburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Baums  |D Mike  |u Department of Orthopaedic Surgery, University of Göttingen Medical Centre (UMG), Georg-August-University, Göttingen, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kostuj  |D Tanja  |u Institute for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Pauly  |D Stephan  |u Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Scheibel  |D Markus  |u Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Carr  |D Andrew  |u Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zargar  |D Nasim  |u Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Saccomanno  |D Maristella  |u Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Milano  |D Giuseppe  |u Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/2(2015-02-01), 530-541  |x 0942-2056  |q 23:2<530  |1 2015  |2 23  |o 167