Our Summary

This research paper is about a study that examined how the body responds to two different types of biological patches, GraftJacket and Permacol, used to help heal rotator cuff injuries. The scientists in this study surgically repaired rotator cuff injuries in some patients and enhanced the repair with one of these patches. In other patients, they did the repair without using a patch. They then took tissue samples from the injured area both during the surgery and four weeks after the surgery.

The researchers found that the patches caused some changes in the tissue compared to the tissue in patients who did not have a patch. They also noticed that the patches did not increase the number of cells, giant cells, or blood vessels in the tissue, compared to the patients without patches.

The most concerning result was that one patient who received the Permacol patch had a strong immune reaction, with a large number of specific types of immune cells infiltrating the tissue. This suggests that the patch may have triggered an inflammatory response.

The study concluded that these patches may not provide any benefit and might even cause harm. More research is needed to better understand the impact of these patches on rotator cuff repair.

FAQs

  1. What are the two types of biological patches mentioned in the study for rotator cuff repair?
  2. What were the findings of the study regarding the impact of the patches on the tissue?
  3. Did the study find any potential risks or negative effects associated with the use of these patches in rotator cuff repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rotator cuff repair is to discuss the use of biological patches with their surgeon and weigh the potential risks and benefits before deciding on whether to use them in their surgery. It’s important for patients to be informed about the latest research findings and to work closely with their healthcare team to ensure the best possible outcome for their rotator cuff injury.

Suitable For

Patients who are typically recommended for rotator cuff repair are those who have a complete tear of the rotator cuff, severe pain and weakness in the shoulder, limited range of motion, and failed conservative treatments such as physical therapy and anti-inflammatory medications. The decision to undergo surgery for rotator cuff repair is often based on the severity of the tear, the patient’s age, activity level, and overall health. Additionally, patients with healthy tissue surrounding the tear are more likely to have successful outcomes with rotator cuff repair.

Timeline

Before rotator cuff repair:

  1. Patient experiences pain, weakness, and limited range of motion in the shoulder.
  2. Patient undergoes physical examination, imaging tests (such as MRI or ultrasound), and possibly non-surgical treatments (such as physical therapy or corticosteroid injections).
  3. If non-surgical treatments are unsuccessful, patient may be recommended for rotator cuff repair surgery.

After rotator cuff repair:

  1. Patient undergoes surgery to repair the torn rotator cuff, which may involve using a biological patch such as GraftJacket or Permacol to enhance the repair.
  2. Patient may experience post-operative pain, swelling, and limited range of motion in the shoulder.
  3. Patient undergoes physical therapy to regain strength and range of motion in the shoulder.
  4. Tissue samples are taken from the repaired area during surgery and four weeks after surgery to assess the healing process.
  5. Research findings suggest that the use of biological patches may not provide any benefit and could potentially cause harm, such as triggering an inflammatory response. Further research is needed to better understand the effects of these patches on rotator cuff repair.

What to Ask Your Doctor

  1. What are the potential benefits of using a biological patch like GraftJacket or Permacol in rotator cuff repair surgery?
  2. Are there any risks or potential complications associated with using these patches in rotator cuff repair surgery?
  3. How does the use of a biological patch like GraftJacket or Permacol affect the healing process of a rotator cuff injury?
  4. Are there any specific factors that would make me a good or bad candidate for using a biological patch in my rotator cuff repair surgery?
  5. Are there alternative treatment options available for rotator cuff injuries that do not involve using a biological patch?
  6. How common is it for patients to have an immune reaction or inflammatory response to a biological patch like Permacol in rotator cuff repair surgery?
  7. What is the long-term outlook for patients who have had a rotator cuff repair surgery with the use of a biological patch like GraftJacket or Permacol?
  8. Are there any specific post-operative care instructions or precautions that I should follow if I choose to have a biological patch used in my rotator cuff repair surgery?
  9. How will the use of a biological patch like GraftJacket or Permacol impact the overall cost of my rotator cuff repair surgery?
  10. Are there any ongoing clinical trials or research studies that are investigating the effectiveness of biological patches in rotator cuff repair surgery that I should be aware of?

Reference

Authors: Rashid MS, Smith RDJ, Nagra N, Wheway K, Watkins B, Snelling S, Dakin SG, Carr AJ. Journal: Acta Orthop. 2020 Dec;91(6):782-788. doi: 10.1080/17453674.2020.1793613. Epub 2020 Jul 21. PMID: 32691656