Grafts and Patches in Rotator Cuff Surgery: Bioinductive Scaffolds, Augmentation, Interposition, and Superior Capsule Reconstruction.

Rotator cuff repair can be challenging because of the compromised state of the tendon tissue. These challenges range from simply degenerative tendons to complete tendon loss in patients which can impair soft-tissue healing. Various grafts and patches are currently available to help address these challenges. The ideal solution for the treatment of irreparable rotator cuff tears or those prone to retear remains controversial. Sometimes augmentation with a patch is appropriate. However, at times a completely retracted and immobile tendon remnant is found. Reconstruction of the superior capsule has demonstrated promising results in several short-term series. The indications for these procedures, the optimal surgical technique, and their limitations are evolving. This chapter discusses the current literature related to bioinductive scaffolds, graft augmentation, graft interposition, and superior capsular reconstruction.

Editorial Commentary: To Scope or Not to Scope: Labral Tears in the Early Arthritic Hip.

As hip arthroscopy is increasingly performed, the indications for surgery still remain unclear. How much arthritis is too much? How do we judge this? At this juncture, we need to better define inclusion and exclusion criteria in our studies, and further studies are needed to shed light on which patients are the best candidates for this procedure.

Arthroscopic Implantation of a Bio-Inductive Collagen Scaffold for Treatment of an Articular-Sided Partial Rotator Cuff Tear.

The treatment of articular-sided partial rotator cuff tears remains a challenge to the treating orthopaedic surgeon. Treatment algorithms have included nonoperative management, debridement alone, and debridement and subacromial decompression, as well as articular-sided rotator cuff repair and completion of the tear on the bursal side followed by a traditional arthroscopic rotator cuff repair. Implantation of a bio-inductive collagen scaffold on the bursal side of the rotator cuff to potentially heal an articular-sided tear represents a novel approach to this difficult clinical entity.

Rehabilitation of biceps tendon disorders in athletes.

The diagnosis and management of an active patient with biceps disease can be challenging for the treating physician. A careful review of the function, anatomy, and pathology of biceps in conjunction with a thorough, knowledgeable history and physical examination can yield a working diagnosis in this challenging patient population. The physician must also be aware of the physiology of postsurgical repair and advocate appropriate rehabilitation activities that correlate with the timeline of secure tissue healing. This article focuses on nonsurgical rehabilitation and postoperative rehabilitation of biceps tendon injuries.