Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleRotator Cuff Repair Using an Acellular Dermal Matrix Graft: An In Vivo Study in a Canine Model
Section snippets
Experimental Design
Approval for this study was obtained from our Institutional Animal Care and Use Committee (IACUC) and guidelines of the National Institutes of Health were followed. Skeletally mature mongrel dogs were used (age >12 months; weight 20 to 35 kg). Eleven animals were randomized to the histologic arm of the study, with survival times of 6 weeks (n = 3), 3 months (n = 4), and 6 months (n = 3). Each animal underwent unilateral surgery on the left shoulder. For the mechanical testing arm of the study,
Clinical Assessment
All animals were ambulatory and were bearing full weight immediately after surgery. No lameness was observed. A single case of superficial wound dehiscence was noted and was adequately managed with percutaneous bacitracin ointment. The wound granulated, and the skin healed without incident.
Gross Findings
With increasing survival time, control and dermal grafts exhibited progressive thickening and formation of a tendon-like structure. This appeared to maximize at 6 weeks (control) and at 3 months (graft);
Discussion
Management of large or massive rotator cuff defects is a difficult problem in orthopaedic practice. Cofield et al.32 investigated outcomes after rotator cuff repair and noted poorer results in patients with large or massive rotator cuff tears who had undergone repair relative to those with small or medium tears. The authors suggested that alternative techniques should be investigated for treatment of these large or massive tears because traditional methods may be less successful in these
Acknowledgments
The authors thank Steven P. Arnoczky, DVM, The Wade O. Brinker Endowed Professor of Surgery, and Director of the Laboratory for Comparative Orthopedic Research at Michigan State University College of Veterinary Medicine, for his invaluable assistance with this study.
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Supported in part by a research grant from Wright Medical Technology, Arlington, Tennessee. Additional institutional support was provided by the Mayo Foundation, Rochester, Minnesota.