Intraoperative Zoledronic Acid for Arthroscopic Rotator Cuff Repair: Short-Term Results From a Prospective,...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Pharmacology

Background:

• High retear rates persist after arthroscopic rotator cuff (RC) repair despite surgical advancements.
• Preclinical research suggests bisphosphonates may improve outcomes post-RC repair.

Purpose of the Study:

• To evaluate the efficacy of a single systemic dose of zoledronic acid in reducing retears following arthroscopic RC repair in patients without osteoporosis.
• To test the hypothesis that zoledronic acid decreases retear incidence after RC repair.

Main Methods:

• A monocentric, prospective, randomized, placebo-controlled, triple-blinded phase II trial (Level of evidence, 1).
• 80 patients were randomized to receive either zoledronic acid or a placebo intraoperatively.
• Outcomes including retear rates (via MRI at 6 months), range of motion, strength, and patient-reported scores (CMS, ASES, SSV, VAS) were assessed preoperatively and at 3 and 6 months post-surgery.

Main Results:

• Zoledronic acid significantly reduced retears at 6 months (15% vs. 35%, P = .001).
• The risk of retear was significantly lower in the zoledronic acid group (RR, 0.43; P = .044).
• Improved clinical and functional outcomes, including abduction, flexion, external rotation, CMS, ASES, SSV, and reduced VAS pain scores, were observed in the zoledronic acid group.

Conclusions:

• A single intraoperative dose of zoledronic acid effectively reduces retears after arthroscopic rotator cuff repair.
• Zoledronic acid presents a safe, easily administered, and cost-effective augmentation strategy for arthroscopic RC repair.