New Techniques Strive to Meet the Challenges of Rotator-Cuff Repair
BY LAUREN UZDIENSKI, JANUARY 28, 2008
When a patient with a rotator-cuff tear has the injury surgically repaired, he or she faces both severe pain associated with the procedure and the possibility that the injury will recur. According to an article (subscription required) in last week's Wall Street Journal, more than half of the patients who undergo the surgery will retear the tissue. The article goes on to describe the new techniques and technologies being developed in an effort to create more positive outcomes for rotator-cuff patients.
Currently, more than 75% of rotator-cuff surgeries are minimally-invasive arthroscopy procedures, which have been shown to reduce length-of-stay (many procedures are outpatient) and blood loss, among other benefits. One new surgical technique involves using double instead of single rows of sutures to reattach the tissue, which could strengthen the repair and reduce the odds of a repeat injury. Still, the technique is still being studied, and there are several detractors: twice as many holes have to be drilled into the bone, which could also be fragile, and the procedure requires double the hardware, which increases costs.
New materials are also on the horizon, including an autologous patch. The patient's blood is put into a centrifuge to isolate platelets that contain various growth factors, which creates a product with a "chewing-gum-like consistency" that can be sutured onto the surgical site. It is currently being evaluated to see if the tear heals more effectively when the blood-clot substance is applied.
With these techniques still in development, physicians emphasize avoiding retears through rehabilitation; physical therapy programs and caution when exercising are integral to positive outcomes. Still, the pressing need for innovative, more effective treatments is clear when considering demographics. The Journal estimates that in the next several years, due to the aging of the baby boomers, there will 500,000 patients requiring rotator-cuff surgery - more than doubling the current patient population.
