Arthroscopic Matrix Augmentation of Partial-Thickness Rotator Cuff Tear Repairs Using a Full-Thickness Human Perinatal Tissue Allograft.
TL;DR
Two patients who were successfully treated with perinatal tissue membrane allograft matrix augmentation (PTAMA) using an arthroscopic onlay technique after failed conservative care are described.
Abstract
Partial-thickness rotator cuff tears (PTRCTs) are common and many progress to full-thickness tears. A persistently symptomatic PTRCT can result in pain, weakness, sleep disturbances, and functional loss. The high incidence, reported progression rates, limited intrinsic healing capability, and functional impairments motivate investigation into effective surgical strategies when conservative care fails. Human perinatal tissue allografts have been previously used for full-thickness rotator cuff tear repair in limited instances, however their fragility makes arthroscopic handling challenging. Herein, we describe two patients who were successfully treated with perinatal tissue membrane allograft matrix augmentation (PTAMA) using an arthroscopic onlay technique after failed conservative care. The perinatal tissue allograft (MLG-COMPLETE; Samaritan Biologics) was found to have handling characteristics that could withstand arthroscopic manipulation and suturing. Following PTAMA, both patients had a significant reduction in pain levels (VAS) at 3 months and improved function (ASES and SANE) at final follow-up (13-15 months). No complications were seen in either patient. At final follow-up, strength and range of motion had returned to normal in both patients. PTRCTs are common and can be challenging to treat. Incorporation of an arthroscopic perinatal tissue membrane allograft onlay is feasible in symptomatic PTRCT after failed conservative treatments.