Use of Nanoscaffold Augmentation in Rotator Cuff Repair: Clinical Outcome and Ultrasound Assessment of Healing Rates and Vascularity

Patients indicated for rotator cuff repair surgery will be offered participation within the study and consented accordingly. A copy of the consent will be provided to the participant. A preoperative ultrasonographic assessment will occur by Dr. Onishi. A randomization process by computer program will determine patients who have Rotium augmented repairs, or not. The patients will not be blinded.

The surgery will be carried out by a single surgeon making all aspects uniform, except if there is or is not a Rotium patch. The Rotium patch will be implanted in accordance to standards of handling sterile implants and placed in a manner that is consistent to its FDA approval. The patch will be furnished by the institution where the surgery is being performed. Digital photography will document pertinent arthroscopic operative findings per standard of care.

Participant assessment will commence preoperatively in an outpatient clinic then continue in postoperative period, occurring at 2, 4, 6 weeks and 3, 6 and 12 month intervals. During each visit, the participants will be assessed by two clinicians: the principal investigator and a blinded ultrasonographer.

Preoperative assessment will include obtaining baseline patient reported outcomes (UCLA, Rowe, Constant, American Shoulder and Elbow Surgeons (ASES) score and SANE (Single Alpha Numeric Evaluation)scores) by paper questionnaire. A medical history will document NSAID use, cortisone injections about the shoulder, tobacco usage, narcotic medicine consumption, and pregnancy status. Due to their deleterious effects on healing, all patients will be instructed to not take NSAIDs in the first 6 weeks postoperative. Noncompliance will be noted, but not disqualify the participant from study. Smoking cessation will be strongly encouraged. A shoulder physical examination will be performed; specifically range of motion assessment in multiple planes (frontal flexion, internal and external rotation at 90 degrees of abduction and at side), rotator cuff muscle strength testing with the scapula stabilized, scapula posture observed, and provocative tests for impingement syndrome. Medical records will be reviewed. This evaluation will be performed by the principal investigator and will take 45-60 minutes. The participant will undergo a separate diagnostic ultrasonographic assessment of the rotator cuff tendons by blinded ultrasonographer. This will take 15-30 minutes.

Aftercare of each population will be identical and will include a 6-week period of sling immobilization, brief perioperative narcotic medicine, and physical therapy. Physical therapy protocols will be identical. The participants will be treated by a variety of physical therapists. All physical therapy will occur out of the home at a PT clinic. Additional home exercises will be furnished and will be independently performed by the participants.