Revision arthroscopic surgery after rotator cuff repair with a collagen graft: histologic evaluation of biopsy specimens from two patients

Rotator cuff tendinopathies are common and can be a significant source of pain and loss of shoulder function.6Chakravarty K. Webley M. Shoulder joint movement and its relationship to disability in the elderly.J Rheumatol. 1993; 20: 1359-1361PubMed Google Scholar,7Lewis J. Mccreesh K. Roy J.S. Ginn K. Rotator cuff tendinopathy: navigating the diagnosis-management conundrum.J Orthopaedic Sports Phys Ther. 2015; 45: 923-937https://doi.org/10.2519/jospt.2015.5941Crossref PubMed Scopus (88) Google Scholar,14Urwin M. Symmons D. Allison T. Brammah T. Busby H. Roxby M. et al.Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation.Ann Rheum Dis. 1998; 57: 649-655Crossref PubMed Scopus (727) Google Scholar Particularly, symptomatic advanced rotator cuff tendinopathy in the absence of a full-thickness tear presents a therapeutic challenge, as surgical options include débridement procedures that do not necessarily address the tendinopathy itself. A similar treatment pitfall applies to partial rotator cuff tears in that rotator cuff tear completion paired with repair opens the possibility of creating a full-thickness defect that does not heal as a complication. One alternative is a repair of the partial tear without completion, although practices vary due to the lack of clear evidence for one optimal treatment recommendation.8Matthewson G. Beach C.J. Nelson A.A. et al.Partial thickness rotator cuff tears: current concepts.Adv Orthop. 2015; 2015: 458786https://doi.org/10.1155/2015/458786Crossref PubMed Scopus (61) Google Scholar New therapeutic modalities that offer biological enhancement of diseased tendons have emerged and show promise in the treatment of advanced rotator cuff tendinopathy.10Murthi A.M. Lankachandra M. Technologies to augment rotator cuff repair.Orthop Clin North America. 2019; 50: 135-140https://doi.org/10.1016/j.ocl.2018.08.005Abstract Full Text Full Text PDF Scopus (17) Google Scholar One such modality is an absorbable collagen implant. These implants may be used for tendon augmentation in the setting of repairs of full-thickness rotator cuff tears, as well as to improve the biological milieu in the surgical treatment of intra-tendinous tendinopathy.1Arnoczky S.P. Bishai S.K. Schofield B. Sigman S. Bushnell B.D. Hommen J.P. et al.Histologic evaluation of biopsy specimens obtained after rotator cuff repair augmented with a highly porous collagen implant.Arthroscopy. 2017; 33: 278-283https://doi.org/10.1016/j.arthro.2016.06.047Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar,10Murthi A.M. Lankachandra M. Technologies to augment rotator cuff repair.Orthop Clin North America. 2019; 50: 135-140https://doi.org/10.1016/j.ocl.2018.08.005Abstract Full Text Full Text PDF Scopus (17) Google Scholar,11Priyavadhana S. Ashraf M. Sakthivelan V. Purudappa P.P. Mounasamy V. Sambandam S. Non-acute rotator cuff tear: repair augmented with Reconstituted Absorbable Collagen Scaffold (RACS)- systematic review.Arch Bone Jt Surg. 2021; 9: 135-140https://doi.org/10.22038/abjs.2020.52764.2612Crossref PubMed Google Scholar,13Thon S.G. O’Malley L. O’Brien M.J. Savoie F.H. Evaluation of healing rates and safety with a bioinductive collagen patch for large and massive rotator cuff tears: 2-Year safety and clinical outcomes.Am J Sports Med. 2019; 47: 1901-1908https://doi.org/10.1177/0363546519850795Crossref PubMed Scopus (28) Google Scholar,15Van Kampen C. Arnoczky S. Parks P. Hackett E. Ruehlman D. Turner A. et al.Tissue-engineered augmentation of a rotator cuff tendon using a reconstituted collagen scaffold: a histological evaluation in sheep.Muscles Ligaments Tendons J. 2013; 3: 229-235https://doi.org/10.11138/mltj/2013.3.3.229Crossref PubMed Scopus (45) Google Scholar These implants have demonstrated improved surgical outcomes such as decreased pain and loss of function and lower revision/re-operation rates.4Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. Van Kampen C. et al.Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2015; 5: 144-150https://doi.org/10.11138/mltj/2015.5.3.144Crossref PubMed Scopus (24) Google Scholar,9McIntyre L.F. Bishai S.K. Brown P.B. Bushnell B.D. Trenhaile S.W. Patient-reported outcomes after use of a bioabsorbable collagen implant to treat partial and full-thickness rotator cuff tears.Arthroscopy. 2019; 35: 2262-2271https://doi.org/10.1016/j.arthro.2019.02.019Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar,13Thon S.G. O’Malley L. O’Brien M.J. Savoie F.H. Evaluation of healing rates and safety with a bioinductive collagen patch for large and massive rotator cuff tears: 2-Year safety and clinical outcomes.Am J Sports Med. 2019; 47: 1901-1908https://doi.org/10.1177/0363546519850795Crossref PubMed Scopus (28) Google Scholar The collagen graft comprises type 1 collagen and serves as a scaffold that is thought to structurally support the repair, thereby decreasing the tensile forces across new and fragile tissue at a repair site, in conjunction with inducing tendon tissue growth.11Priyavadhana S. Ashraf M. Sakthivelan V. Purudappa P.P. Mounasamy V. Sambandam S. Non-acute rotator cuff tear: repair augmented with Reconstituted Absorbable Collagen Scaffold (RACS)- systematic review.Arch Bone Jt Surg. 2021; 9: 135-140https://doi.org/10.22038/abjs.2020.52764.2612Crossref PubMed Google Scholar,14Urwin M. Symmons D. Allison T. Brammah T. Busby H. Roxby M. et al.Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation.Ann Rheum Dis. 1998; 57: 649-655Crossref PubMed Scopus (727) Google Scholar In a sheep study, the graft’s porosity has been shown to promote host tissue ingrowth into the graft, forming mature tendon-like tissue and thickening the rotator cuff tendons.15Van Kampen C. Arnoczky S. Parks P. Hackett E. Ruehlman D. Turner A. et al.Tissue-engineered augmentation of a rotator cuff tendon using a reconstituted collagen scaffold: a histological evaluation in sheep.Muscles Ligaments Tendons J. 2013; 3: 229-235https://doi.org/10.11138/mltj/2013.3.3.229Crossref PubMed Scopus (45) Google Scholar Similarly, histologic evaluation of seven patients’ repair augmented with a collagen graft showed findings of host tissue ingrowth within the graft and mature tissue formation and organization along the graft.1Arnoczky S.P. Bishai S.K. Schofield B. Sigman S. Bushnell B.D. Hommen J.P. et al.Histologic evaluation of biopsy specimens obtained after rotator cuff repair augmented with a highly porous collagen implant.Arthroscopy. 2017; 33: 278-283https://doi.org/10.1016/j.arthro.2016.06.047Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar The new and thicker tissue is believed to offload further and decrease rotator cuff strain, optimize healing potential, and reduce the rate of tendon re-tear.1Arnoczky S.P. Bishai S.K. Schofield B. Sigman S. Bushnell B.D. Hommen J.P. et al.Histologic evaluation of biopsy specimens obtained after rotator cuff repair augmented with a highly porous collagen implant.Arthroscopy. 2017; 33: 278-283https://doi.org/10.1016/j.arthro.2016.06.047Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar,15Van Kampen C. Arnoczky S. Parks P. Hackett E. Ruehlman D. Turner A. et al.Tissue-engineered augmentation of a rotator cuff tendon using a reconstituted collagen scaffold: a histological evaluation in sheep.Muscles Ligaments Tendons J. 2013; 3: 229-235https://doi.org/10.11138/mltj/2013.3.3.229Crossref PubMed Scopus (45) Google Scholar Multiple clinical studies have demonstrated that tendon repair augmented with a collagen implant induces significant tendon thickening and tear resolution on MRI by 12 months follow-up.2Bokor D.J. Sonnabend D.H. Deady L. Cass B. Young A.A. Van Kampen C.L. et al.Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: A 5-year clinical and MRI follow-up.Muscles Ligaments Tendons J. 2019; 9: 338-347https://doi.org/10.32098/mltj.03.2019.07Crossref Scopus (2) Google Scholar, 3Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. van Kampen C. et al.Evidence of healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2016; 6: 16-25https://doi.org/10.11138/mltj/2016.6.1.016Crossref PubMed Scopus (30) Google Scholar, 4Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. Van Kampen C. et al.Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2015; 5: 144-150https://doi.org/10.11138/mltj/2015.5.3.144Crossref PubMed Scopus (24) Google Scholar, 5Bushnell B.D. Connor P.M. Harris H.W. Ho C.P. Trenhaile S.W. Abrams J.S. Retear rates and clinical outcomes at 1 year after repair of full-thickness rotator cuff tears augmented with a bioinductive collagen implant: a prospective multicenter study.JSES Int. 2021; 5: 228-237https://doi.org/10.1016/j.jseint.2020.10.020Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar,12Schlegel T.F. Abrams J.S. Bushnell B.D. Brock J.L. Ho C.P. Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study.J Shoulder Elbow Surg. 2018; 27: 242-251https://doi.org/10.1016/j.jse.2017.08.023Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar,13Thon S.G. O’Malley L. O’Brien M.J. Savoie F.H. Evaluation of healing rates and safety with a bioinductive collagen patch for large and massive rotator cuff tears: 2-Year safety and clinical outcomes.Am J Sports Med. 2019; 47: 1901-1908https://doi.org/10.1177/0363546519850795Crossref PubMed Scopus (28) Google Scholar Patient-reported clinical scores such as single-assessment numeric evaluation (SANE), American Shoulder and Elbow Surgeons (ASES) scores, and the Western Ontario’s Rotator Cuff (WORC) scores have also been shown to improve after repair with a collagen graft.2Bokor D.J. Sonnabend D.H. Deady L. Cass B. Young A.A. Van Kampen C.L. et al.Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: A 5-year clinical and MRI follow-up.Muscles Ligaments Tendons J. 2019; 9: 338-347https://doi.org/10.32098/mltj.03.2019.07Crossref Scopus (2) Google Scholar, 3Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. van Kampen C. et al.Evidence of healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2016; 6: 16-25https://doi.org/10.11138/mltj/2016.6.1.016Crossref PubMed Scopus (30) Google Scholar, 4Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. Van Kampen C. et al.Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2015; 5: 144-150https://doi.org/10.11138/mltj/2015.5.3.144Crossref PubMed Scopus (24) Google Scholar, 5Bushnell B.D. Connor P.M. Harris H.W. Ho C.P. Trenhaile S.W. Abrams J.S. Retear rates and clinical outcomes at 1 year after repair of full-thickness rotator cuff tears augmented with a bioinductive collagen implant: a prospective multicenter study.JSES Int. 2021; 5: 228-237https://doi.org/10.1016/j.jseint.2020.10.020Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar,12Schlegel T.F. Abrams J.S. Bushnell B.D. Brock J.L. Ho C.P. Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study.J Shoulder Elbow Surg. 2018; 27: 242-251https://doi.org/10.1016/j.jse.2017.08.023Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar,13Thon S.G. O’Malley L. O’Brien M.J. Savoie F.H. Evaluation of healing rates and safety with a bioinductive collagen patch for large and massive rotator cuff tears: 2-Year safety and clinical outcomes.Am J Sports Med. 2019; 47: 1901-1908https://doi.org/10.1177/0363546519850795Crossref PubMed Scopus (28) Google Scholar Despite their promising clinical profile, collagen implants may have potential adverse outcomes, namely subacute reactive bursitis. We report two cases of reactive bursitis after rotator cuff repair with a collagen implant, capitalizing on the opportunity to evaluate graft integration and native tissue quality and rule out infectious or inflammatory reactions to the graft. These reports serve to characterize the clinical, radiographic, arthroscopic, and histologic findings after rotator cuff repair augmented with a collagen scaffold. Therein, this study provides insight into the clinical presentation, revision of surgery recommendations, and short-term outcomes. The first patient is a 74-year-old, right-hand dominant male with atraumatic chronic left shoulder pain and dysfunction. The pain, which he rated as 10/10, had bothered him for years, frequently interfering with his activities of daily living. Three years earlier, the patient successfully underwent repair of a right shoulder full-thickness rotator cuff tear. His medical history included chronic obstructive pulmonary disease (COPD), formerly heavy smoking (150 pack-years), osteoarthritis, and osteoporosis. On examination, the patient exhibited diminished active abduction and forward elevation, pain with passive external rotation with no external rotation lag, tenderness to palpation over the bicipital groove, and positive impingement signs. MRI at presentation showed intrasubstance partial-thickness high-grade tears of the left supraspinatus and infraspinatus tendons and biceps tendinopathy (Fig. 1). Given that extensive conservative therapies, including several rounds of physical therapy and corticosteroid injections, did not relieve his pain, the patient was not interested in additional conservative management. The risks and benefits of surgical intervention were explained, and the patient elected to proceed with surgery. The arthroscopic procedure occurred four months after the initial evaluation. Peripheral nerve block and general anesthesia were given without complication. Glenohumeral portals were established in the posterior soft spot and rotator interval. The intra-articular portion of the long head of the biceps tendon was noted to have significant erythema and synovitis. It was detached from its anchor at the superior glenoid labrum and retrieved via a separate open subpectoral incision and tenodesis. Subacromial arthroscopic evaluation revealed partial-thickness fraying of the bursal side of supraspinatus without a full-thickness tear (Fig. 2). Because of the extensive tendinopathy noted on MRI and partial tearing of the supraspinatus, a collagen scaffold was placed to augment the supraspinatus. The scaffold was introduced into the subacromial space through the lateral portal, deployed, and then secured on top of the existing cuff with four poly L-lactide (PLLA) sutures and two lateral bone staples. For the initial two months postoperatively, the patient did well, with minimal reports of pain and improving functionality with physical therapy. However, three months postoperatively, the patient reported an acute atraumatic increase in left shoulder pain, not relieved with conservative management and rated as 10/10. An MRI taken three months postoperatively showed improvement in rotator cuff tendon thickness and decreased signal heterogeneity at the site of intrasubstance tear; however, there was subacromial and subdeltoid fluid consistent with reactive bursitis (Fig. 3). The patient failed conservative treatments, and after discussing the risks and benefits, the patient consented to an arthroscopic evaluation and débridement to resolve his symptoms and exclude an infectious etiology. The revision surgery occurred the following month. Arthroscopic portals were established as described above, and arthroscopic evaluation showed that the glenohumeral joint was unremarkable. Subacromial evaluation, however, demonstrated significant subacromial and subdeltoid inflammation and adhesions. While the deep layer of the scaffold was well-integrated into the underlying rotator cuff, the superficial layer of the collagen scaffold had delaminated and flipped into the subdeltoid recess. Representative scar tissue in the lateral subdeltoid recess noted on MRI (Fig. 3) was similarly observed arthroscopically. The remaining scaffold, however, seemed to have integrated with the now normal appearing rotator cuff (Fig. 4). The loose, superficial scaffold material was removed from the subdeltoid recess, and the two lateral PEEK bone staples and any sutures were A was and were along the subacromial and of the and subdeltoid recess. The of graft, bursal and sutures were for histologic Similarly, including the scaffold, and PEEK bone were for and were for three and in no The histological evaluation into the scaffold without evidence of or a inflammatory the graft (Fig. from one revision surgery scaffold biopsy at and The biopsy was at the of the arthroscopic revision surgery and was in The was in and to tissue to in were and then with and The scaffold was successfully on as by its and are the collagen scaffold. no evidence of inflammatory the scaffold. On the of the there is a with of type by type A is no evidence of or inflammation of the The patient physical and at seven months after his revision he has been well, with his pain improved after the no further The patient is a with a medical history of and to with two months of right shoulder pain by The pain after the patient out of right demonstrated no evidence of or On presentation to three months right shoulder pain On examination, exhibited a positive tenderness to palpation over the long head of the biceps and and positive rotator cuff impingement signs. MRI revealed partial-thickness tearing of the right supraspinatus, and on high-grade as well as biceps and subacromial bursitis (Fig. Given significant and lack of to treatments, the patient to surgical management after discussing the and benefits of surgical months the patient underwent an arthroscopic right shoulder and biceps and a rotator cuff augmentation with the type of collagen scaffold (Fig. as described in from rotator cuff augmentation for partial thickness fraying of cuff, with of The collagen graft was with The patient well months postoperatively right shoulder from the active of which had to after the was and exhibited impingement signs. A subacromial corticosteroid to the and of underwent a demonstrated subacromial bursitis with to the rotator cuff tendon exhibited decreased signal heterogeneity intrasubstance with intrasubstance partial tear of the rotator cuff (Fig. Given the of subacromial fluid and for an was that was for an infectious after for On three months pain by medical and corticosteroid A MRI was that demonstrated improvement of the rotator cuff tendons with further decreased heterogeneity of However, the bursal and subacromial bursitis (Fig. including risks and benefits, were and the patient elected for surgical MRI for after and conservative management. subacromial bursitis with evidence of of the bursal rotator cuff tendons and graft surgical occurred two months and showed rotator cuff subacromial bursitis and and fraying of the (Fig. The subacromial space was of and along with a biopsy of the graft (Fig. were obtained and for and described in the included from the graft, bone and sutures for and infectious was A subacromial was showed tissue with inflammation (Fig. The demonstrated integration of the graft with native as on arthroscopic (Fig. On the initial the patient was well with no reports of pain or loss of symptoms of and pain at were findings in revision surgery specimens from in which were for were revision arthroscopic surgery. was used for was used for by for of and was used for tissue for using a or a tissue the tissue was in were with a and on These were with and using an of normal with a layer of and of the with of the with chronic inflammation by A separate scaffold can no be rotator cuff tears surgical management are and new management and to A.M. Lankachandra M. Technologies to augment rotator cuff repair.Orthop Clin North America. 2019; 50: 135-140https://doi.org/10.1016/j.ocl.2018.08.005Abstract Full Text Full Text PDF Scopus (17) Google Scholar are to not outcomes also of and adverse outcomes that may surgical and of One such at the is a collagen scaffold for rotator cuff and outcomes have been D.J. Sonnabend D.H. Deady L. Cass B. Young A.A. Van Kampen C.L. et al.Healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a highly-porous collagen implant: A 5-year clinical and MRI follow-up.Muscles Ligaments Tendons J. 2019; 9: 338-347https://doi.org/10.32098/mltj.03.2019.07Crossref Scopus (2) Google Scholar, 3Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. van Kampen C. et al.Evidence of healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2016; 6: 16-25https://doi.org/10.11138/mltj/2016.6.1.016Crossref PubMed Scopus (30) Google Scholar, 4Bokor D.J. Sonnabend D. Deady L. Cass B. Young A. Van Kampen C. et al.Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2015; 5: 144-150https://doi.org/10.11138/mltj/2015.5.3.144Crossref PubMed Scopus (24) Google Scholar,9McIntyre L.F. Bishai S.K. Brown P.B. Bushnell B.D. Trenhaile S.W. Patient-reported outcomes after use of a bioabsorbable collagen implant to treat partial and full-thickness rotator cuff tears.Arthroscopy. 2019; 35: 2262-2271https://doi.org/10.1016/j.arthro.2019.02.019Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar,12Schlegel T.F. Abrams J.S. Bushnell B.D. Brock J.L. Ho C.P. Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study.J Shoulder Elbow Surg. 2018; 27: 242-251https://doi.org/10.1016/j.jse.2017.08.023Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar,13Thon S.G. O’Malley L. O’Brien M.J. Savoie F.H. Evaluation of healing rates and safety with a bioinductive collagen patch for large and massive rotator cuff tears: 2-Year safety and clinical outcomes.Am J Sports Med. 2019; 47: 1901-1908https://doi.org/10.1177/0363546519850795Crossref PubMed Scopus (28) Google Scholar In the current study, two revision out of a of over successfully treatment this implant. In the two reported after the showed improved of and decreased pain Similarly, after augmentation with the collagen scaffold, tendon on MRI and by Collagen scaffold augmentation is an to rotator cuff by improving tendon quality and clinical outcomes, there is the of a and partial graft that be as potential Because reports underwent revision had the opportunity to and the collagen scaffold with native cuff The arthroscopic findings with of decreased signal heterogeneity the rotator cuff, improvement in intrasubstance following the of a collagen scaffold. In a portion of the scaffold was histological of the and of the scaffold revealed that this portion of the scaffold showed histological integration with native with the improved tendon on well with the findings of histologic integration reported in large Kampen C. Arnoczky S. Parks P. Hackett E. Ruehlman D. Turner A. et al.Tissue-engineered augmentation of a rotator cuff tendon using a reconstituted collagen scaffold: a histological evaluation in sheep.Muscles Ligaments Tendons J. 2013; 3: 229-235https://doi.org/10.11138/mltj/2013.3.3.229Crossref PubMed Scopus (45) Google Scholar and S.P. Bishai S.K. Schofield B. Sigman S. Bushnell B.D. Hommen J.P. et al.Histologic evaluation of biopsy specimens obtained after rotator cuff repair augmented with a highly porous collagen implant.Arthroscopy. 2017; 33: 278-283https://doi.org/10.1016/j.arthro.2016.06.047Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar four months after one integration with host into the in by the of revision months after the graft to be and integrated into host well with Arnoczky et S.P. Bishai S.K. Schofield B. Sigman S. Bushnell B.D. Hommen J.P. et al.Histologic evaluation of biopsy specimens obtained after rotator cuff repair augmented with a highly porous collagen implant.Arthroscopy. 2017; 33: 278-283https://doi.org/10.1016/j.arthro.2016.06.047Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar for graft no evidence of inflammatory to the graft with this scaffold. the scaffold seemed to host tissue ingrowth and revision due to reactive bursitis a to the to the absorbable of the graft, or the joint and graft at a of reactive bursitis from investigation revealed consistent with reactive bursitis. were given and of a however, infectious to be and cases without the cases to be consistent with a reactive infectious bursitis. the portion of a scaffold that was delaminated in one may have to the reactive bursitis through and with the graft. the of this study was not on reactive bursitis with the use of a collagen implant, findings on this are consistent with one patient in et D.J. Sonnabend D. Deady L. Cass B. Young A. van Kampen C. et al.Evidence of healing of partial-thickness rotator cuff tears following arthroscopic augmentation with a collagen implant: A 2-year MRI follow-up.Muscles Ligaments Tendons J. 2016; 6: 16-25https://doi.org/10.11138/mltj/2016.6.1.016Crossref PubMed Scopus (30) Google Scholar study bursitis 12 months rotator cuff repair, and tissue and were to have no evidence of Bushnell et B.D. Connor P.M. Harris H.W. Ho C.P. Trenhaile S.W. Abrams J.S. Retear rates and clinical outcomes at 1 year after repair of full-thickness rotator cuff tears augmented with a bioinductive collagen implant: a prospective multicenter study.JSES Int. 2021; 5: 228-237https://doi.org/10.1016/j.jseint.2020.10.020Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar that one patient débridement and of due to inflammatory on MRI three months rotator cuff One patient in et L.F. Bishai S.K. Brown P.B. Bushnell B.D. Trenhaile S.W. Patient-reported outcomes after use of a bioabsorbable collagen implant to treat partial and full-thickness rotator cuff tears.Arthroscopy. 2019; 35: 2262-2271https://doi.org/10.1016/j.arthro.2019.02.019Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar study and bursitis débridement and that in the setting of cases of graft of histologic evaluation was be to the collagen graft augmentation and reactive bursitis. Rotator cuff repair or augmentation with a collagen scaffold augmentation rotator cuff tendon and The histologic evaluation that the collagen implant with native tissue and does not to a in the setting of reactive bursitis. collagen scaffold augmentation be of the possibility of reactive bursitis. of reactive bursitis may to be with surgical débridement to treat symptoms and and rule out with Despite this histologic and MRI findings support the use of this implant for rotator cuff and partial thickness

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.