Voss Andreas, McCarthy Mary Beth, Allen Donald, Cote Mark P, Beitzel Knut, Imhoff Andreas B, Mazzocca Augustus D
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.
Arthrosc Tech. 2016 May 2;5(3):e447-51. doi: 10.1016/j.eats.2016.01.029. eCollection 2016 Jun.
With an increase in the aging population, rotator cuff tears are becoming more common. High failure rates with shoulder rotator cuff repair surgery have been persistent, prompting the introduction of biologic methods to promote healing. The aim of the present technique is to deliver stem cells and growth factors to the footprint of the repair site. A platelet-rich plasma (PRP) fibrin clot is used as a scaffold for the delivery of stem cells, by using PRP, to provide a source of growth factors, and platelet-poor plasma (PPP) as a source for fibrinogen for the matrix for the scaffold. In the second step, bone marrow is harvested from the proximal humerus, concentrated, and combined with the PRP and PPP. Using a customized device, we then activate the clotting process and transfer the scaffold containing the stem cells using a suture anchor onto the shoulder rotator cuff footprint. In an effort to promote healing, this technique reimplants autologous stem cells and growth factors into the operative site. This technique may serve as an alternative for typically used scaffolds such as collagen matrices or decellularized human dermis patches.
随着老龄化人口的增加，肩袖撕裂变得越来越普遍。肩袖修复手术的高失败率一直存在，这促使人们引入生物方法来促进愈合。本技术的目的是将干细胞和生长因子输送到修复部位的足迹处。富含血小板的血浆（PRP）纤维蛋白凝块被用作输送干细胞的支架，通过使用PRP来提供生长因子的来源，而贫血小板血浆（PPP）则作为支架基质中纤维蛋白原的来源。在第二步中，从肱骨近端采集骨髓，进行浓缩，并与PRP和PPP混合。然后，我们使用定制设备激活凝血过程，并使用缝合锚将含有干细胞的支架转移到肩袖足迹处。为了促进愈合，该技术将自体干细胞和生长因子重新植入手术部位。该技术可作为通常使用的支架（如胶原基质或脱细胞人真皮贴片）的替代方法。
