Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 2: Rotator Cuff.
Rotator cuff tears are common and result in considerable morbidity. Tears within the tendon substance or at its insertion into the humeral head represent a considerable clinical challenge because of the hostile local environment that precludes healing. Tears often progress without intervention, and current surgical treatments are inadequate. Although surgical implants, instrumentation, and techniques have improved, healing rates have not improved, and a high failure rate remains for large and massive rotator cuff tears. The use of biologic adjuvants that contribute to a regenerative microenvironment have great potential for improving healing rates and function after surgery. This article presents a review of current and emerging biologic approaches to augment rotator cuff tendon and muscle regeneration focusing on the scientific rationale, preclinical, and clinical evidence for efficacy, areas for future research, and current barriers to advancement and implementation.
The University of Edinburgh, Edinburgh, UK.
Iain R
IR
Murray
Steadman Philippon Research Institute, Vail, Colorado, USA.
Robert F
RF
LaPrade
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Volker
V
Musahl
Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
Andrew G
AG
Geeslin
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Jason P
JP
Zlotnicki
Author deceased.; American Orthopaedic Society for Sports Medicine, Rosemont, Illinois, USA.
Barton J
BJ
Mann
University of California, Los Angeles, California, USA.
Frank A
FA
Petrigliano
biologic healing enhancement; biology of tendon; growth factors/healing enhancement; rotator cuff; stem cell therapy; tendinosis