Lets look at some new information, focusing on patient reported outcomes rather than MRI findings.
Recently, the authors of No Short-term Clinical Benefit to Bovine Collagen Implant
Augmentation in Primary Rotator Cuff Repair: A Matched
Retrospective Study used a single surgeon, minimum two year retrospective, matched, comparative study of patients who underwent primary arthroscopic repair of partial or full-thickness rotator cuff tears to determine (1) whether the proportion of patients undergoing re-operation for postoperative stiffness and inflammation differed between patients having cuff repair with a bovine collagen implant (Regeneten) and patients having cuff repair without the implant, (2) whether short-term patient-reported outcomes differed between the two groups, and (3) whether the proportion of patients receiving postoperative methylprednisolone prescriptions and corticosteroid injections differed between the two groups.
They found that a greater proportion of patients in the bovine collagen implant group (9% [4 of 47]) underwent reoperation for inflammation and stiffness than in the control group (0% [0 of 94]). At minimum 2-year follow-up, patients receiving the Regeneten implant did not have better reported outcomes: American Shoulder and Elbow Surgeon score (81 ± 24 implant versus 85 ±19 control, SSV (79 ± 24 implant versus 85 ± 18 control), VAS score for pain (2.0 ± 2.9 implant versus 1.5 ± 2.3 control). The cohorts did not differ in the proportion who received postoperative corticosteroid injections or methylprednisolone prescriptions.
They concluded that “at minimum 2-year follow-up, patients undergoing primary arthroscopic rotator cuff repair with bovine collagen implant augmentation had a greater proportion of re-operation due to inflammation and stiffness compared with patients who did not receive the implant. Furthermore, the implant offered no benefit in patient-reported outcomes or need for postoperative corticosteroid injections or methylprednisolone prescriptions. Because of the lack of clinical benefit and potential increase in postoperative complications, we recommend against the use of these bovine collagen implants unless high-quality randomized controlled trials are able to demonstrate their clinical effectiveness, cost-effectiveness, and overall safety.”
The authors of Effect of Porcine-Derived Absorbable
Patch-Type Atelocollagen for Arthroscopic
Rotator Cuff Repair compared standard rotator cuff repair to repair with a type-I atelocollagen absorbable patch derived from pigs (RegenSeal) in patients having rotator cuff repair. For the atelocollagen group, before securing the lateral anchors, porcine-derived absorbable patch-type atelocollagen was inserted between the footprint and the tendon. They found no significant differences in pre to postoperative improvement in Constant Score, pain, other functional scores, and range of motion between the groups at 1 year postoperatively.
