Rotator Cuff Augmentation and Revision

Surgical Technique


The problem: Massive tears have the highest failure rates

Many surgeons and their patients would prefer rotator cuff repair over joint replacement. Even with advances in rotator cuff repair techniques and technology in recent years, tissue quality, biomechanical forces and lack of a good vascular supply1,2,3,4 have led to reported failure rates of as high as 68%in large to massive tears (Grades III and IV).  However, surgeons who use a biologic scaffold and innovative anchors like the Y-Knot RC are achieving higher success rates while still preserving the joint.2,4

The solution: Augment the repair with an Extracellular Matrix (ECM) scaffold
In large tears and revisions, poor tissue quality is one of the biggest obstacles to performing a successful repair. By augmenting the tissue with an ECM scaffold like Allopatch HD®, peer reviewed research has shown that surgeons can potentially go from a 40%2 success rate without augmentation to an 85.7%4 success rate with augmentation.

Among the available scaffold types, clinical studies have shown that ECMs like Allopatch HD® are stronger – exhibiting better suture retention and greater ultimate load failure rates than synthetics and xenografts.3

Take the uncertainty out of choosing the right ECM with Allopatch HD®

  • No Prep Time Required

Unlike other ECMs that need to be hydrated for 60 minutes or longer before being used – delaying completion of the procedure and prolonging OR time – Allopatch HD requires no refrigeration or rehydration and it is ready to use off the shelf almost immediately.

  • Minimally Processed

Allopatch HD is minimally processed and not crosslinked which better preserves and maintains the graft’s natural biomechanical, biochemical and matrix properties.

  • Tissue Quality – Not all Allografts are the Same

While it is often assumed that all allograft tissue is the same, tissue quality can actually vary greatly depending on the standards of the tissue bank. MTF Biologics, the tissue bank that supplies CONMED the allograft tissue, has some of the most stringent donor selection standards of any tissue bank in the world, which allows MTF Biologics to process aseptically, thus preserving the tissues natural biomechanical and biochemical properties. 

Videos – Surgical Techniques

Product

Allopatch HD®

  • Minimally processed
  • Minimal prep time


Y-Knot® RC with Tape All-Suture Anchor

  • 2.8mm footprint provides placement and fixation advantages when bone real estate is limited
  • Simple, self-punching technique
  • 69% less abrasive than the leading competitor when measuring tendon tear-through5


Y-Knot® RC All-Suture Anchor

  • 2.8mm footprint provides placement and fixation advantages when bone real estate is limited
  • Simple, self-punching technique
  • Secure 360-degree FormFit™ Fixation


CrossFT™ Knotless Suture Anchor

  • Controlled tension designed to optimize tendon compression
  • Strong dual-thread pattern for cortical and cancellous bone fixation
  • Bone marrow vent channel designed to provide healing properties of bone marrow


Y-Knot® Flex All-Suture Anchors

  • Soft: All-suture anchors
  • Small: Minimal footprint
  • Secure: 360-degree FormFit™ Fixation
 
CrossFT™and GENESYS CrossFT™ Suture Anchor

  • CrossFT (PEEK) and GENESYS CrossFT (biocomposite) offer dual-thread pattern for cortical and cancellous bone fixation
  • Bone marrow vent channel designed to provide healing properties of bone marrow


PopLok® Knotless Suture Anchors – 3.5/4.5mm

  • Ability to tension suture after the anchor is seated
  • Wings are deployed subcortically to provide secure fixation

 
  

 

1Jost B, Pfirrmann CWA, Gerber C. Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 2000; 82:304-14.) 

2Barber FA, Burns JP, Deutsch A, Labbé MR, Litchfield RB.. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy. 2012 Jan;28(1):8-15. doi: 10.1016/j.arthro.2011.06.038. Epub 2011 Oct 5. 

3Barber, FA, Aziz-Jacobo J. Biomechanical testing of commercially available soft-tissue augmentation materials. Arthroscopy
2009;25:1233-1239. 

4Agrawal, V. Healing rates for challenging rotator cuff tears utilizing an acellular human dermal reinforcement graft.Int J Shoulder Surg. 2012 Apr;6(2):36-44. doi: 10.4103/0973-6042.96992.

5Data on File TR16-787. Compared with FiberTape.


This material provides information regarding how to use CONMED medical devices and instruments in surgical procedures.  Although reviewed by physicians it is not medical advice and each surgeon should use their own professional judgment before using to treat a particular patient.  Surgeons should be trained in the use of such devices before surgery and should always refer to the product labeling including the Instructions for Use before using any medical device.

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