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Massive Rotator Cuff Tears pp 81–89Cite as

Biologics and Patches

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Abstract

Over the past decade, surgical instrumentation and repair constructs have improved the biomechanical strength of rotator cuff repairs, making mechanical failure rare. Most recurrent rotator cuff tears are thought to be due to the compromised biological environment at the relatively avascular healing site. Treatments that augment the biology of rotator cuff healing provide the potential to improve patient outcomes following repair. Most of the research focusing on enhancing tendon healing is in the preclinical stages. The most promising of this research will be reviewed here, but the focus of the chapter will be on modalities available to surgeons now including platelet rich plasma (PRP) and patches. To date, results of PRP augmentation in the setting of large rotator cuff repairs are not very promising. Patches can help when used in the appropriate setting. It is important to note that patient selection is a critical element of improving outcomes. Perhaps the most effective way to currently improve the biological environment of rotator cuff repairs is to optimize medical conditions such as diabetes and smoking cessation.

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Acknowledgement

Figures courtesy of Gary Gartsman MD.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA

    Phillip N. Williams MD

  2. Rutgers New Jersey Medical School, Medical Sciences Building, 185 South Orange Ave, Newark, NJ, 07103, USA

    Jaydev B. Mistry BA

  3. Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA

    Joshua S. Dines MD

  4. Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, USA

    Joshua S. Dines MD

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  1. Phillip N. Williams MD
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  3. Joshua S. Dines MD
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Correspondence to Joshua S. Dines MD .

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Editors and Affiliations

  1. Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA

    Lawrence V. Gulotta

  2. Professor of clinical surgery, Attending Surgeon, Medical School, Hospital for Special Surgery, New York, New York, USA

    Edward V. Craig

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Williams, P.N., Mistry, J.B., Dines, J.S. (2015). Biologics and Patches. In: Gulotta, L., Craig, E. (eds) Massive Rotator Cuff Tears. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7494-5_6

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  • DOI: https://doi.org/10.1007/978-1-4899-7494-5_6

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