Saturday, January 4, 2014

A 'new' patch for rotator cuff repairs. Is this BBC news?

Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates

This article by the BBC talks of the promise of a "protective patch, which wraps round soft tissue repairs" that will be trialled in patients with shoulder injuries.

The article reports that 10,000 shoulder repair operations are carried out each year in England and Wales and that figure has risen by 500% in the last decade. "But one in four procedures is not successful, because the tendon tears again."

This report is based on laboratory tests that have been encouraging, but clinical trials have yet to begin. The team claims, "We've used modern technology to produce very fine fibres which have the extraordinary ability to direct the way cells behave, and "wake up" tired and aging cells, and make them want to heal, whereas previously they weren't being made to want to heal. The material in the patch is degradable, and disappears after a few months."

While we're all for research in improving the currently suboptimal anatomical and clinical results of cuff repair, it seems a bit early to for the BBC to be proclaiming the promise of the 'degradable implant'. Here are some previous posts on attempts to improve the biology of tendon healing in cuff repair.

Platelet-leukocyte membrane
Platelet fibrin matrix
Platelet rich plasma

It has been proposed that Graft Jacket may be useful in this regard, but results of a clinical trial have yet to be reported. The trial started in 2007 and was to be completed in 2010. We'd be most interested if any of the readers know of a results report.

A terrific review of 'patches' is provided here from the Wrightington Upper Limb Unit - a must read!

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