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Intraoperative Channeling in Arthroscopic Rotator Cuff Repair: A Multicenter Randomized Controlled Trial.

Peter Lapner1, Martin Bouliane2, J W Pollock1

  • 1Division of Orthopaedic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.

The American Journal of Sports Medicine
|December 1, 2022
PubMed
Summary

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Bone channeling did not improve healing rates or patient outcomes in arthroscopic rotator cuff repair. This study found no significant difference between bone channeling augmentation and standard repair for rotator cuff tears.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Regenerative Medicine

Background:

  • Rotator cuff repair has a high retear rate despite advances in arthroscopic techniques.
  • Bone channeling is a novel method proposed to enhance rotator cuff healing by stimulating cellular and growth factor responses.
  • Optimizing healing rates in rotator cuff repair remains a critical clinical challenge.

Purpose of the Study:

  • To compare healing rates after arthroscopic rotator cuff repair with and without bone channeling augmentation.
  • To evaluate the impact of bone channeling on patient-reported outcomes, including pain and function.
  • To assess the efficacy of bone channeling as an adjuvant to standard arthroscopic rotator cuff repair.

Main Methods:

  • A randomized controlled trial (Level of evidence, 1) involving 168 patients with degenerative rotator cuff tears.
Keywords:
arthroscopic surgerybone channelingcrimson duvetmicrofracturerandomized controlled trialrotator cuff tearshouldershoulder joint

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  • Patients were randomized to receive either arthroscopic rotator cuff repair with bone channeling or standard arthroscopic repair.
  • Healing was assessed by ultrasound at 24 months, with functional outcomes measured using WORC, ASES, Constant, and VAS scores.

    • Main Results:

    • No statistically significant difference in healing rates was observed between the bone channeling group and the control group at 24 months postoperatively.
    • Both groups showed significant improvements in all measured functional outcome scores (WORC, ASES, Constant, VAS) from baseline.
    • There were no significant differences in functional outcome scores between the bone channeling and standard repair groups at any postoperative time point.

    Conclusions:

    • Intraoperative bone channeling did not demonstrate superiority over standard arthroscopic rotator cuff repair in terms of healing rates or patient-reported outcomes at 24 months.
    • The findings suggest that bone channeling augmentation does not significantly enhance the outcomes of arthroscopic rotator cuff repair.
    • Further research may be needed to explore alternative or modified techniques for improving rotator cuff healing.