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Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma

PURPOSE: To evaluate the clinical outcomes of patients who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, concentrated bone marrow aspirate (cBMA), and platelet-rich plasma. METHODS: Sixteen patients were included in the study who underwent arthroscopic rotator cuff re...

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Autores principales: Muench, Lukas N., Kia, Cameron, Berthold, Daniel P., Uyeki, Colin, Otto, Alexander, Cote, Mark P., McCarthy, Mary Beth, Beitzel, Knut, Arciero, Robert A., Mazzocca, Augustus D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754610/
https://www.ncbi.nlm.nih.gov/pubmed/33376995
http://dx.doi.org/10.1016/j.asmr.2020.07.019
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author Muench, Lukas N.
Kia, Cameron
Berthold, Daniel P.
Uyeki, Colin
Otto, Alexander
Cote, Mark P.
McCarthy, Mary Beth
Beitzel, Knut
Arciero, Robert A.
Mazzocca, Augustus D.
author_facet Muench, Lukas N.
Kia, Cameron
Berthold, Daniel P.
Uyeki, Colin
Otto, Alexander
Cote, Mark P.
McCarthy, Mary Beth
Beitzel, Knut
Arciero, Robert A.
Mazzocca, Augustus D.
author_sort Muench, Lukas N.
collection PubMed
description PURPOSE: To evaluate the clinical outcomes of patients who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, concentrated bone marrow aspirate (cBMA), and platelet-rich plasma. METHODS: Sixteen patients were included in the study who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, cBMA, and platelet-rich plasma from January 2018 to July 2018 and had a minimum 1-year follow-up. American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test, Constant-Murley, and Single Assessment Numerical Evaluation (SANE) scores were collected preoperatively and at terminal follow-up. To determine the clinical relevance of ASES scores, the minimal clinically important difference, substantial clinical benefit, and the patient acceptable symptomatic state thresholds were used. In vitro cellular proliferation of subacromial bursa (nucleated cells/gram) and cBMA (nucleated cells and colony-forming units/cc) samples was evaluated and correlated to clinical outcomes scores. RESULTS: Mean follow-up was 12.6 ± 1.8 months (range 12-19 months). Patients achieved significant improvement in ASES (45.8±22.5(pre) vs 88.5 ± 14.6(post,) Δ44.7 ± 20.7; P = .001), Simple Shoulder Test (4.3 ± 3.2(pre) vs 10.4 ± 1.6(post), Δ5.7 ± 3.9, P = .002), Constant-Murley (44.3 ± 18.2(pre) vs 83.6 ± 17.5(post,) Δ37.2 ± 21.8; P = .001), SANE (13.3 ± 10.7(pre) vs 86.3 ± 17.5(post,) Δ71.9 ± 22.9; P = .001), and pain scores (5.0±2.8(pre) vs 1.1 ± 1.6(post,) Δ3.5±2.5, P = .001) at final follow-up. With regards to ASES score, 93.8% of patients achieved the minimal clinically important difference, 93.8% the substantial clinical benefit, and 62.5% reached or exceeded the patient acceptable symptomatic state criteria. There was a significant positive correlation of nucleated cell count of cBMA with postoperative SANE score (r = 0.707; P = .015) and delta in ASES score (r = 0.727; P = .011). All other correlations were found to be nonsignificant (P > .05, respectively). CONCLUSIONS: Patients undergoing arthroscopic rotator cuff repair augmented using the Mega-Clot with bursa technique achieved significant improvement in functional outcomes at a minimum 1-year follow-up, with 93.8% of patients reaching substantial clinical benefit. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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spelling pubmed-77546102020-12-28 Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma Muench, Lukas N. Kia, Cameron Berthold, Daniel P. Uyeki, Colin Otto, Alexander Cote, Mark P. McCarthy, Mary Beth Beitzel, Knut Arciero, Robert A. Mazzocca, Augustus D. Arthrosc Sports Med Rehabil Original Article PURPOSE: To evaluate the clinical outcomes of patients who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, concentrated bone marrow aspirate (cBMA), and platelet-rich plasma. METHODS: Sixteen patients were included in the study who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, cBMA, and platelet-rich plasma from January 2018 to July 2018 and had a minimum 1-year follow-up. American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test, Constant-Murley, and Single Assessment Numerical Evaluation (SANE) scores were collected preoperatively and at terminal follow-up. To determine the clinical relevance of ASES scores, the minimal clinically important difference, substantial clinical benefit, and the patient acceptable symptomatic state thresholds were used. In vitro cellular proliferation of subacromial bursa (nucleated cells/gram) and cBMA (nucleated cells and colony-forming units/cc) samples was evaluated and correlated to clinical outcomes scores. RESULTS: Mean follow-up was 12.6 ± 1.8 months (range 12-19 months). Patients achieved significant improvement in ASES (45.8±22.5(pre) vs 88.5 ± 14.6(post,) Δ44.7 ± 20.7; P = .001), Simple Shoulder Test (4.3 ± 3.2(pre) vs 10.4 ± 1.6(post), Δ5.7 ± 3.9, P = .002), Constant-Murley (44.3 ± 18.2(pre) vs 83.6 ± 17.5(post,) Δ37.2 ± 21.8; P = .001), SANE (13.3 ± 10.7(pre) vs 86.3 ± 17.5(post,) Δ71.9 ± 22.9; P = .001), and pain scores (5.0±2.8(pre) vs 1.1 ± 1.6(post,) Δ3.5±2.5, P = .001) at final follow-up. With regards to ASES score, 93.8% of patients achieved the minimal clinically important difference, 93.8% the substantial clinical benefit, and 62.5% reached or exceeded the patient acceptable symptomatic state criteria. There was a significant positive correlation of nucleated cell count of cBMA with postoperative SANE score (r = 0.707; P = .015) and delta in ASES score (r = 0.727; P = .011). All other correlations were found to be nonsignificant (P > .05, respectively). CONCLUSIONS: Patients undergoing arthroscopic rotator cuff repair augmented using the Mega-Clot with bursa technique achieved significant improvement in functional outcomes at a minimum 1-year follow-up, with 93.8% of patients reaching substantial clinical benefit. LEVEL OF EVIDENCE: Level IV, therapeutic case series. Elsevier 2020-10-05 /pmc/articles/PMC7754610/ /pubmed/33376995 http://dx.doi.org/10.1016/j.asmr.2020.07.019 Text en © 2020 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Muench, Lukas N.
Kia, Cameron
Berthold, Daniel P.
Uyeki, Colin
Otto, Alexander
Cote, Mark P.
McCarthy, Mary Beth
Beitzel, Knut
Arciero, Robert A.
Mazzocca, Augustus D.
Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title_full Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title_fullStr Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title_full_unstemmed Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title_short Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma
title_sort preliminary clinical outcomes following biologic augmentation of arthroscopic rotator cuff repair using subacromial bursa, concentrated bone marrow aspirate, and platelet-rich plasma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754610/
https://www.ncbi.nlm.nih.gov/pubmed/33376995
http://dx.doi.org/10.1016/j.asmr.2020.07.019
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