2021 Annual Meeting Shoulder Access Pass-Questions and Answers: Massive Rotator Cuff

Video Transcription

Video Summary

The video transcript features a panel discussion where questions from the audience are answered. The first question is directed to Dr. Verma, who explains why a spacer was compared to partial repairs rather than an SCR (superior capsular reconstruction). Dr. Verma states that partial repair is historically considered the gold standard for managing massive rotator cuff tears, and they wanted a fair comparison in terms of using implants in each group. The next question is about the criteria for determining an irreparable repair in the in-space study, to which the response is that it was determined at the discretion of the surgeon based on factors such as tear size, tear morphology, and muscle atrophy. The following question is about the potential degradation and impact of the implant on the shoulder joint, to which it is explained that the implant is usually resorbed by 12 months and did not cause any deleterious changes to the articular surface, soft tissue, or bone in the study. The next question pertains to the age criteria for the implant, with concern over younger patients. Dr. Verma mentions that a subgroup analysis showed better outcomes for patients over 65, but the sweet spot for the intervention is lower demand patients who have maintained function, experience pain, and have failed conservative treatments. Lastly, Jillian briefly discusses the hypotheses behind the improved scores in the study, including the spacer effect of the graft and potential pain-modulating effects of SCR.

Asset Caption

Nikhil Verma, MD; Ian Lo, MD; Riccardo Compagnoni, MD; Gillian Kane, BS

Keywords

partial repair

implants

in-space study

irreparable repair

subgroup analysis