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pADM patch augmentation for rotator cuff repair: In vivo safety and efficacy in a canine model
Jianbo Li1,2, Qingjun Kong2, Qian Xu2
1Department of Pathology, Xiangya Hospital, School of Basic Medical Science, Central South University, Changsha, Hunan, China.
Objective:
Rotator cuff repair remains challenged by a high postoperative retear rate, particularly in moderate-to-large tears and in patients with poor tendon quality, where conventional suture-anchor fixation often fails to provide sufficient mechanical support during the healing process. This study aimed to systematically evaluate the in vivo safety, degradation characteristics, and reparative efficacy of a porcine-derived acellular dermal matrix (pADM) patch for rotator cuff augmentation in a large animal model.
Methods:
Bilateral infraspinatus tendon insertion injury models were established in 24 adult beagle dogs. Animals in the test group received pADM patch augmentation in combination with suture-anchor fixation, whereas those in the control group underwent conventional anchor repair alone. Comprehensive assessments including hematological analysis, gross observation, CT/MRI images, histopathology (HE and Masson staining), and biomechanical testing were performed at 2, 4, 6, and 13 weeks postoperatively.
Results:
Implantation of the pADM patch elicited no abnormal inflammatory or immune responses, indicating favorable biocompatibility. Imaging and histology analyses demonstrated superior tendon structural restoration and enhanced tendon-bone integration in the test group. The patch underwent progressive degradation and achieved effective host-tissue integration. Biomechanical testing revealed significantly higher maximum failure loads in the test group at all time points, indicating superior mechanical integrity of the repaired tendon (P < 0.05).
Conclusion:
The pADM patch exhibits favorable biosafety and biocompatibility, promotes tendon structure recovery and tendon-bone healing, and enhances biomechanical strength. Its degradation kinetics match the host tissue remodeling process, with complete resorption by 13 weeks. This acellular dermal matrix patch represents a safe and effective augmentation material for rotator cuff repair, with promising potential for clinical translation.
