J Am Acad Orthop Surg Glob Res Rev. 2025 Oct 7;9(10). doi: 10.5435/JAAOSGlobal-D-25-00295. eCollection 2025 Oct 1.
ABSTRACT
BACKGROUND: Bioinductive collagen implants (BCIs) have been growing in popularity for use in rotator cuff repair (RCR) over the past several years, but recent literature has raised concerns about the implants contributing to postoperative stiffness. The purpose of this study was to investigate the incidence of stiffness over a decade of experience with the BCI.
METHODS: A retrospective review was conducted of all cases of RCR using a BCI performed between September 2014 and December 2023. The primary outcome measure was postoperative range of motion, with significant stiffness defined by parameters in the existing literature. The secondary outcome measure was any revision procedure for stiffness.
RESULTS: After application of inclusion and exclusion criteria to 522 cases of RCR, there were 432 cases (390 individual patients) available for outcome analysis with an average follow-up of 34.9 months (range, 6 months to 9.25 years). There were only 12 cases (2.8%) of significant postoperative stiffness. All of them required additional operative intervention for stiffness, and all but two patients had at least one risk factor for stiffness. Stiffness rates were 4 of 291 (1.4%) for full-thickness tears and 8 of 141 (5.7%) for partial-thickness tears (P = 0.0149).
CONCLUSION: This study, the largest single cohort to date analyzing BCIs in RCR, found a low incidence of significant postoperative stiffness in cases associated with the use of the implant. Stiffness rates were markedly higher for repairs of partial-thickness tears. To further improve understanding of postoperative stiffness after RCR with BCI, better definitions and prospective comparative studies across larger groups are needed.
LEVEL OF EVIDENCE: Level IV, retrospective cohort with no comparison group.
PMID:41061192 | DOI:10.5435/JAAOSGlobal-D-25-00295
