Beleckas Casey M, Bishai Shariff K, Badman Brian L
Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Associated Orthopedists of Detroit, Saint Clair Shores, Michigan, U.S.A.
Arthrosc Tech. 2022 Dec 21;12(1):e77-e81. doi: 10.1016/j.eats.2022.08.061. eCollection 2023 Jan.
Despite advances in arthroscopic rotator cuff repair, failure rates up to 94% have been reported in the literature for large tears, with rates as high as 36% for small and medium tears. One strategy for improving outcomes is augmentation with a patch, which has typically been incorporated onto the bursal portion of the repaired tendon and been made up of either dermal or bovine collagen tissue. The Rotium wick (Atreon Orthopedics, Columbus, OH)-an interpositional augmentation-is a nanofiber scaffold that is meant to be sandwiched between the rotator cuff and humerus at the bone-tendon interface and is currently the only implant approved by the US Food and Drug Administration to be used in this manner. The scaffold works to improve the cellular organization of the basement membrane during tendon healing at the enthesis and, in a recent sheep study, has been shown to better replicate the natural Sharpey-like fibers similar to the native tendon and increase the strength of the repair more rapidly. The purpose of this Technical Note is to describe the means for use of an interpositional nanofiber scaffold for arthroscopic rotator cuff repair.
尽管关节镜下肩袖修复技术取得了进展，但文献报道大型肩袖撕裂的失败率高达94%，中小型撕裂的失败率高达36%。一种改善治疗效果的策略是使用补片进行增强修复，补片通常被置于修复肌腱的滑囊侧，由真皮或牛胶原蛋白组织制成。Rotium Wick（Atreon Orthopedics公司，俄亥俄州哥伦布市）是一种用于间置增强的纳米纤维支架，旨在夹置于肩袖与肱骨之间的骨-肌腱界面处，它是目前美国食品药品监督管理局批准的唯一可按此方式使用的植入物。该支架有助于在肌腱愈合过程中改善附着点处基底膜的细胞组织排列，并且在最近一项针对绵羊的研究中表明，它能更好地复制类似于天然肌腱的Sharpey样纤维，并更快地增强修复强度。本技术说明的目的是描述用于关节镜下肩袖修复的间置纳米纤维支架的使用方法。
