Document Type
Article
Publication Date
8-2012
Publication Title
Journal of Shoulder and Elbow Surgery
Abstract
Background
Scaffolds continue to be developed and used for rotator cuff repair augmentation; however, the appropriate scaffold material properties and/or surgical application techniques for achieving optimal biomechanical performance remains unknown. The objectives of the study were to simulate a previously validated spring-network model for clinically relevant scenarios to predict: (1) the manner in which changes to components of the repair influence the biomechanical performance of the repair and (2) the percent load carried by the scaffold augmentation component.
Materials and methods
The models were parametrically varied to simulate clinically relevant scenarios, namely, changes in tendon quality, altered surgical technique(s), and different scaffold designs. The biomechanical performance of the repair constructs and the percent load carried by the scaffold component were evaluated for each of the simulated scenarios.
Results
The model predicts that the biomechanical performance of a rotator cuff repair can be modestly increased by augmenting the repair with a scaffold that has tendon-like properties. However, engineering a scaffold with supraphysiologic stiffness may not translate into yet stiffer or stronger repairs. Importantly, the mechanical properties of a repair construct appear to be most influenced by the properties of the tendon-to-bone repair. The model suggests that in the clinical setting of a weak tendon-to-bone repair, scaffold augmentation may significantly off-load the repair and largely mitigate the poor construct properties.
Conclusions
The model suggests that future efforts in the field of rotator cuff repair augmentation may be directed toward strategies that strengthen the tendon-to-bone repair and/or toward engineering scaffolds with tendon-like mechanical properties.
Recommended Citation
Aurora, A., McCarron, J. A., van den Bogert, A.J., Gatica, J. E., Iannotti, J. P., & Derwin, K. A. (2012). The biomechanical role of scaffolds in augmented rotator cuff tendon repairs. Journal of Shoulder and Elbow Surgery, 21(8), 1064-1071. doi: 10.1016/j.jse.2011.05.014
DOI
10.1016/j.jse.2011.05.014
Version
Postprint
Publisher's Statement
NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Shoulder and Elbow Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Shoulder and Elbow Surgery, 21, 8, (08-01-2012); 10.1016/j.jse.2011.05.014
Volume
21
Issue
8
