caa a22 4500 605460205 CHVBK 20210128100237.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00167-014-3487-2 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3487-2 Advances in biology and mechanics of rotator cuff repair [Elektronische Daten] [Olaf Lorbach, Mike Baums, Tanja Kostuj, Stephan Pauly, Markus Scheibel, Andrew Carr, Nasim Zargar, Maristella Saccomanno, Giuseppe Milano] 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. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 Rotator cuff nationallicence Biology nationallicence Biomechanics nationallicence Growth factors nationallicence Augmentation nationallicence Cell therapy nationallicence Lorbach Olaf Department of Orthopaedic Surgery, Saarland University, Homburg, Germany aut Baums Mike Department of Orthopaedic Surgery, University of Göttingen Medical Centre (UMG), Georg-August-University, Göttingen, Germany aut Kostuj Tanja Institute for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany aut Pauly Stephan Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany aut Scheibel Markus Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany aut Carr Andrew Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK aut Zargar Nasim Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK aut Saccomanno Maristella Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy aut Milano Giuseppe Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/2(2015-02-01), 530-541 0942-2056 23:2<530 2015 23 167 https://doi.org/10.1007/s00167-014-3487-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3487-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lorbach Olaf Department of Orthopaedic Surgery, Saarland University, Homburg, Germany aut NATIONALLICENCE 700 1- Baums Mike Department of Orthopaedic Surgery, University of Göttingen Medical Centre (UMG), Georg-August-University, Göttingen, Germany aut NATIONALLICENCE 700 1- Kostuj Tanja Institute for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany aut NATIONALLICENCE 700 1- Pauly Stephan Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany aut NATIONALLICENCE 700 1- Scheibel Markus Center for Muskuloskeletal Surgery, Charité Universitaetsmedizin, Berlin, Germany aut NATIONALLICENCE 700 1- Carr Andrew Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK aut NATIONALLICENCE 700 1- Zargar Nasim Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Institute, University of Oxford, Oxford, UK aut NATIONALLICENCE 700 1- Saccomanno Maristella Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy aut NATIONALLICENCE 700 1- Milano Giuseppe Division of Orthopaedic Surgery, Department of Orthopaedics, "A. Gemelli” University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, RM, Italy aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/2(2015-02-01), 530-541 0942-2056 23:2<530 2015 23 167