Our Summary

This research paper discusses the rapidly evolving field of orthobiologics, which is the use of biological substances to help injuries heal faster. Specifically, it looks at their potential in improving healing after rotator cuff repair (a surgery for a common shoulder injury).

The paper mentions two substances: platelet-rich plasma (PRP) and atelocollagen (a synthetic collagen substitute). PRP is a concentration of a patient’s own platelets, which are involved in clotting and wound healing, while atelocollagen is used to provide more collagen (a protein found in the body that promotes healing) for the injury site.

The authors note that the evidence for the effectiveness of PRP in rotator cuff repair is still not clear-cut. However, it has been well-studied, appears safe, and may improve healing for larger injuries and overall outcomes of the surgery.

Atelocollagen, on the other hand, doesn’t have much data on its effectiveness.

The paper emphasizes the need for careful consideration of these biological treatments for safety and effectiveness, and encourages continuous exploration of new techniques to improve patient outcomes.

In simpler terms, the researchers are saying that while using substances like PRP and atelocollagen might help shoulder injuries heal better after surgery, more research is needed to really know how well they work.

FAQs

  1. What is the role of orthobiologics in rotator cuff repair (RCR)?
  2. How effective is the use of substances like platelet-rich plasma (PRP) and Atelocollagen in RCR?
  3. What are the potential improvements in patient outcomes with the use of PRP in RCR?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rotator cuff repair is to discuss the potential benefits and risks of biologic augmentation options such as platelet-rich plasma (PRP) with their surgeon. While PRP has shown some promise in improving healing of large to massive tears and RCR outcomes, the clinical evidence is not yet definitive. It is important for patients to have a thorough understanding of the options available and to work closely with their healthcare team to determine the best course of treatment for their individual case.

Suitable For

Patients who are typically recommended for rotator cuff repair include those with large to massive tears, chronic tears that have failed conservative management, tears in younger, active patients who want to maintain shoulder function, and tears that are causing significant pain and functional limitations. Additionally, patients who are healthy enough to undergo surgery and commit to a post-operative rehabilitation program are good candidates for rotator cuff repair.

Timeline

  • Before rotator cuff repair: The patient typically experiences shoulder pain, weakness, and limited range of motion. They may have previously tried conservative treatments such as physical therapy and corticosteroid injections with limited success. Imaging studies like MRI may show a rotator cuff tear.

  • Rotator cuff repair surgery: The patient undergoes arthroscopic or open surgery to repair the torn rotator cuff tendons. The surgeon may use sutures or anchors to reattach the tendon to the bone.

  • Immediately after surgery: The patient is typically placed in a sling to protect the repaired tendon and is instructed to perform gentle range of motion exercises. Pain and swelling are common during this initial phase.

  • Weeks to months after surgery: The patient undergoes physical therapy to gradually strengthen the shoulder and improve range of motion. They may experience some discomfort and stiffness during this period.

  • 6 months to 1 year after surgery: The patient continues with physical therapy and gradually returns to normal activities. Full recovery can take up to a year, with some patients experiencing ongoing improvements in shoulder function over time.

  • Overall, the success of rotator cuff repair surgery depends on various factors such as the size and location of the tear, the patient’s age and overall health, and adherence to postoperative rehabilitation. Biologic augmentation techniques like PRP may potentially enhance the healing process and improve outcomes, but further research is needed to fully understand their efficacy in rotator cuff repair.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rotator cuff repair surgery?

  2. What is the expected recovery time and rehabilitation process after rotator cuff repair surgery?

  3. Are there any alternative treatment options to surgery for my rotator cuff injury?

  4. How successful is rotator cuff repair surgery in terms of pain relief and functional improvement?

  5. Will I need physical therapy after the surgery, and if so, how long will I need to participate in therapy?

  6. What type of anesthesia will be used during the surgery, and what are the potential side effects?

  7. How many rotator cuff repair surgeries have you performed, and what is your success rate?

  8. Are there any specific lifestyle changes or modifications I should make after the surgery to aid in the healing process?

  9. Will I need to take any medications after the surgery, and if so, what are the potential side effects?

  10. What are the long-term expectations for my shoulder function after rotator cuff repair surgery?

Reference

Authors: Volkmer DL. Journal: Arthroscopy. 2024 Nov;40(11):2678-2680. doi: 10.1016/j.arthro.2024.04.005. Epub 2024 Apr 16. PMID: 38636907