Back to Search
Start Over
The use of a patch to augment rotator cuff surgery – A survey of UK shoulder and elbow surgeons
- Source :
- PLoS ONE, PLoS ONE, Vol 15, Iss 4, p e0230235 (2020)
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- Background: Rotator cuff tears are a common cause of shoulder pain and can result in prolonged periods of pain, disability and absence from work. Rotator cuff repair surgery is increasingly used in an attempt to resolve symptoms but has failure rates of around 40%. There is a pressing need to improve the outcome of rotator cuff repairs. Patch augmentation increasingly being used within the NHS in an attempt to reduce repair failures. The aim of this survey was to determine current UK practice and opinion relating to the factors that influence choice of patch, current patient selection and willingness to assist with generation of improved evidence. Methods: An online survey was sent to the surgeon members of the British Elbow and Shoulder Society (BESS). Questions covered respondent demographics, experience with patches, indications for patch augmentation and willingness to be involved in a randomised trial of patch augmented rotator cuff surgery. Results: The response rate was 105/550 (19%). 58% of respondents had used a patch to augment rotator cuff surgery. 70% of patch users had undertaken an augmented repair within the last 6 months. A wide surgical experience in augmentation was reported (ranging 1 to 200 implants used). However, most surgeons reported low volume usage, with a median of 5 rotator cuff augmentation procedures performed. At least 10 different products had been used. Most of the patches used were constructed from human decellularised dermis tissue, although porcine derived and synthetic based patches had also been used. Only 3–5% stated they would undertake an augmented repair for small tears across ages, whereas 28–40% and 19–59% would do so for large or massive tears respectively. When assessing patient suitability, patient age seemed relevant only for those with large and massive tears. Half of the surgeons reported an interest in taking part in a randomised controlled trial (RCT) evaluating the role of patch augmentation for rotator cuff surgery, with a further 22% of respondent’s undecided. Conclusions: A variety of patches have been used by surgeons to augment rotator cuff repair with a wide range of operator experience. There was substantial uncertainty about which patch to use and differing views on which patients were most suitable. There is a clear need for robust clinical evaluation and further research in this area.
- Subjects :
- Male
Medical Doctors
Physiology
Swine
Health Care Providers
Elbow
Surveys
Rotator Cuff Injuries
law.invention
Tendons
Arthroscopy
Rotator Cuff
0302 clinical medicine
Randomized controlled trial
law
Surveys and Questionnaires
Medicine and Health Sciences
Medical Personnel
Aged, 80 and over
Response rate (survey)
030222 orthopedics
Multidisciplinary
medicine.diagnostic_test
Augmentation procedure
030503 health policy & services
Uncertainty
Prostheses and Implants
Middle Aged
Professions
Treatment Outcome
medicine.anatomical_structure
Research Design
Connective Tissue
Medicine
Female
Anatomy
Augment
0305 other medical science
Research Article
Shoulder
medicine.medical_specialty
Drug Research and Development
Science
Clinical Decision-Making
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Arthroplasty
03 medical and health sciences
Musculoskeletal System Procedures
Shoulder Pain
Physicians
Tissue Repair
medicine
Animals
Humans
Clinical Trials
Rotator cuff
Aged
Surgeons
Pharmacology
Surgical repair
Survey Research
business.industry
Biology and Life Sciences
Randomized Controlled Trials
United Kingdom
Surgery
Health Care
Biological Tissue
Surgical Repair
People and Places
Population Groupings
Clinical Medicine
Physiological Processes
Elbow Injuries
business
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....713d5d11433f2cbfdb0a9b469492986b