Rotator Cuff Repair Using an Acellular Dermal Matrix Graft: An In Vivo Study in a Canine Model

Julie E. Adams, Mark E. Zobitz, John S. Reach, Kai Nan An, Scott P. Steinmann

Research output: Contribution to journalArticle

147 Scopus citations

Abstract

Purpose: Large rotator cuff tears present a challenge to orthopaedic surgeons. Because tissue may be insufficient or of inadequate quality to undergo repair, a variety of materials have been used as adjuncts. Human dermal tissue may be processed to render it acellular, and thus less immunogenic, but with the extracellular matrix left intact, creating a collagen scaffold with favorable characteristics. Because of these traits, use in rotator cuff repair was proposed. Methods: A canine model for a full-thickness infraspinatus tendon tear was used. Tendon was excised from the bony interface to the myotendinous junction, and a human acellular dermal matrix graft (experimental) or the autologous excised tendon (control) was used to bridge the defect. Animals were sacrificed, and shoulders were evaluated histologically and biomechanically. Results: At time 0, strength of control and experimental repairs was similar. At 6 weeks, the strength of the experimental repair was half that of the control side. Strength of control specimens remained the same at 6 and 12 weeks, but by 12 weeks, the strength of the experimental repair was equal to that of the control. Histologically, cells infiltrated the control and experimental specimens by 6 weeks; chronic inflammation was consistent with surgery and repair. At 6 months, control and experimental specimens mimicked normal tendon structure grossly and histologically. Conclusions: Use of human acellular dermal matrix as a patch is a viable option in this model of large rotator cuff defects. Within 6 weeks, histologic evidence of native cell infiltration and neotendon development was observed. Within 12 weeks, the strength of the dermal matrix graft repair was equivalent to that of autologous tendon. At 6 months, control and graft specimens mimicked normal tendon structure grossly and histologically. Clinical Relevance: This study provides in vivo animal data to support the use of this acellular dermal matrix graft for repair of full-thickness rotator cuff defects. Additional studies are indicated to determine the role of this material in the treatment of humans with rotator cuff tears.

Original languageEnglish (US)
Pages (from-to)700-709
Number of pages10
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2006

Keywords

  • Full-thickness rotator cuff defect
  • Irreparable rotator cuff tear
  • Patch graft
  • Rotator cuff
  • Rotator cuff repair

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Rotator Cuff Repair Using an Acellular Dermal Matrix Graft: An In Vivo Study in a Canine Model'. Together they form a unique fingerprint.

  • Cite this