Arthroscopic Rotator Cuff Repair Technique Using a Bio-Composite Scaffold for Tissue Augmentation.

The use of biologics and rotator cuff augmentation have seen significant growth in interest to combat complications of rotator cuff retear after arthroscopic rotator cuff repair. Bio-inductive implants are used to induce new tissue formation; however, they lack structural strength at the time of implantation. Conversely, dermal allografts are used to provide structural strength at implantation, but they do not allow for sufficient tissue incorporation and carry inherent risks of allograft tissue. The BioBrace™ (Biorez, New Haven, CT) is a bio-inductive scaffold composed of highly porous type I collagen and bio-resorbable poly (l-lactide) microfilaments developed to combat the latter drawbacks. The unique bio-composite properties provide the ability to combine the benefits of bio-induction and strength into a single implant. We propose a successful, reproducible technique for the implantation of BioBrace for rotator cuff augmentation.

Minimally Invasive Posterior Cervical Fusion With Facet Cages to Augment High-Risk Anterior Cervical Arthrodesis: A Case Series.

STUDY DESIGN: Retrospective case series. OBJECTIVES: To evaluate the efficacy and results of minimally invasive posterior cervical fusion with facet cages as an augment to high-risk patients and patients status post multilevel anterior cervical decompression and fusion. METHODS: Thirty-five patients with symptomatic cervical stenosis with high risk for pseudoarthrosis underwent circumferential cervical decompression and fusion via staged anterior and posterior approach. Anterior cervical decompression and fusion was performed first by means of the standard anterior approach, with the patient supine on the operating table. The patients were subsequently flipped into a prone position and minimally invasive posterior cervical facet fusion with DTRAX was performed. The patients were then followed in the outpatient clinic for an average of 312.71 days. Postoperative patient satisfaction scores were obtained via the visual analogue scale (VAS). Preoperative VAS scores were compared with postoperative VAS scores in order to evaluate patient outcomes. RESULTS: Of the 35 patients evaluated, minimum follow-up was 102 days, with a maximum follow-up of 839 days. Average preoperative and postoperative VAS scores were 7.6 and 2.8, respectively (P < .0001), with an average improvement of 4.86 points. This was an average improvement of 64.70% from preoperative to postoperative. Seventeen patients had excellent outcomes, with a postoperative VAS score ≤2. Seven patients achieved a postoperative VAS score of 0, with 100% improvement of preoperative pain and symptoms. Average blood loss was 70.38 mL. Average length of stay was 1.03 days. CONCLUSIONS: The results indicate that minimally invasive posterior cervical decompression and fusion with facet cages, when combined with standard anterior cervical decompression and fusion, is an effective means of obtaining circumferential cervical fusion while simultaneously improving patient outcomes.