Surgical Repair and Augmentation of a Large Type-2 Re-tear of the Rotator Cuff with a Novel Biocomposite Scaffold: A Case Report

Abstract

Case A 55-year-old female presented with pain and weakness in her right shoulder after a new traumatic event occurred. She had undergone a rotator cuff repair to this right shoulder 4 months earlier with dermal strip augmentation secondary to poor tissue quality at the time of index surgery. For historical context, her contralateral shoulder had undergone a previous primary rotator cuff repair with xenograft, which failed, and was ultimately revised to a full thickness repair 2 years prior. A repeat MRI demonstrated a recurrent large type-II rotator cuff tear with grade 3 Goutallier fatty infiltration. A novel biocomposite scaffold (BioBrace™) was used to augment a revision double row bridge repair with margin convergence. MRI at three and eight months after surgery suggested functional remodeling and growth of new tissue. At 10 months, arthroscopy was performed to evaluate bicipital pain and arthroscopic images demonstrated full incorporation of the biocomposite scaffold within the underlying native tendon and an intact repair. The source of bicipital pain was unrelated to the implant and a biceps tenodesis was performed to resolve the pain. Clinical outcomes were assessed preoperatively and at 1 year postoperatively using the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) Shoulder Score, and Single Assessment Numeric Evaluation (SANE). Conclusion The use of a novel biocomposite scaffold augmentation for revision rotator cuff repair demonstrated evidence of healing, incorporation, and remodeling at 10 months post-procedure. VAS, ASES, and SANE pre- and post-operative outcome scores were analyzed at 1 year demonstrating significant improvement across all metrics. This case report suggests the use of a novel biocomposite rotator cuff augment can provide a via option for revision rotator cuff repair.