Introduction

Rotator cuff injuries are a common source of pain and discomfort for many individuals. Whether caused by sports-related trauma or general wear and tear, these injuries can significantly impact one’s quality of life. Traditional rotator cuff repair methods often involve sutures and anchors, which can be invasive and may lead to complications.

Fortunately, the field of orthopaedics is continually advancing, and one of the most exciting innovations in recent years is the Xiros Pitch-Patch for rotator cuff repair. In this article, we explore this groundbreaking technology and how it’s changing the game in the world of orthopaedic surgery.

 

Understanding the Rotator Cuff

Before delving into the Pitch-Patch, let’s briefly review what the rotator cuff is and why its proper function is crucial. The rotator cuff is a group of muscles and tendons in the shoulder that plays a vital role in maintaining the shoulder’s stability and enabling a wide range of arm movements. When these muscles and tendons are damaged, it can result in pain, weakness, and limited mobility. Rotator cuff injuries are often seen in athletes, older adults, and those engaged in repetitive overhead activities.

 

The Challenges of Rotator Cuff Repair

Traditional surgical methods for rotator cuff repair involve suturing the torn tendons back to the bone using anchors and sutures. While these methods have proven effective, they do have their drawbacks:

1. Invasiveness: Traditional surgery requires large incisions, which can lead to more pain, longer recovery times, and an increased risk of infection.

2. Risk of Re-tearing: The repaired tendons can sometimes re-tear, leading to the need for additional surgeries.

3. Prolonged Rehabilitation: Recovery and rehabilitation can be lengthy and challenging.

 

The Pitch-Patch Solution

The Pitch-Patch was devised by Dr. Med. Jan Leuzinger of the etzelclinic, Pfäffikon, Switzerland with first implantations in 2012. As rotator cuff (RC) repair techniques developed, with improved anchors, high strength sutures and effective suture passing devices, RC repair still suffered from reported high re-tear rates. [1, 2, 3]

The remaining weak link was the quality of the native tissue available for repair. A number of patch techniques and materials have been devised for the repair of massive RC tears. Dr Leuzinger proposed a poly-ethylene terephthalate (polyester) anatomically shaped and reinforced device, that would offer immediate strength and allow a standardised rehabilitation programme determined by the underlying tissue repair and not modified due to the patch itself.

A study published in the JSES in 2019 concluded for the Pitch-Patch; “patch augmentation in massive RC reconstruction leads to a substantially lower retear rate.” [4]

 

Key Features of the Pitch-Patch

The Pitch-Patch is a single use implantable device constructed from a warp knitted fabric with integral eyelets. The device is indicated for patients requiring reinforcement of the rotator cuff where either the tear cannot be completely repaired using normal methods and/or the quality of the soft tissue is poor.

• Flexible: Suitable for arthroscopic or open technique.

• Strong: A very high average strength of over 400 N when fully sutured along the medial edge (3 sutures) for the standard patch [5].

• Tissue quality: Indicated for patients where either the rotator cuff tear cannot be completely repaired using normal methods and/or the quality of the soft tissue is poor.

• Tissue integration: The warp knitted structure allows a natural body response whereby native tissue integrates into the device.

• Anatomical design: Designed to fit the anatomy, the Pitch-Patch is available in two sizes to cover different tear sizes of the rotator cuff.

 

In the world of orthopaedic surgery, innovations like the Xiros Pitch-Patch are changing the landscape of rotator cuff repair. Patients suffering from rotator cuff injuries can now benefit from a less invasive, faster, and more effective treatment option. As technology continues to advance, we can expect further breakthroughs that will improve the quality of care and outcomes for orthopaedic patients.

If you have patients with a rotator cuff injury, consider discussing the benefits of the Pitch-Patch with your local Xiros representative. It may be the key to a quicker, more successful recovery and a return to a pain-free, active lifestyle for your patients.

 

Find out more

Contact us at xiros.co.uk/contact-us/

 

Sources

  1. Chung SW, Kim JY, Kim MH, Kim SH, Oh JH. Arthroscopic Repair of Massive Rotator Cuff Tears: Outcome and Analysis of Factors Associated With Healing Failure or Poor Postoperative Function. The American Journal of Sports Medicine. 2013;41(7):1674-1683. doi:10.1177/0363546513485719 
  2. Kim JR, Cho YS, Ryu KJ, Kim JH. Clinical and radiographic outcomes after arthroscopic repair of massive rotator cuff tears using a suture bridge technique: assessment of repair integrity on magnetic resonance imaging. Am J Sports Med. 2012 Apr;40(4):786- 93. doi: 10.1177/0363546511434546. Epub 2012 Feb 3. PMID: 22307079.
  3. Choi S, Kim MK, Kim GM, Roh YH, Hwang IK, Kang H. Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears. J Shoulder Elbow Surg. 2014 Nov;23(11):1675-81. doi: 10.1016/j.jse.2014.02.021. Epub 2014 May 24. PMID: 24862247.
  4. Smolen D, Haffner N, Mittermayr R, Hess F, Sternberg C, Leuzinger J. Application of a new polyester patch in arthroscopic massive rotator cuff repair-a prospective cohort study. J Shoulder Elbow Surg. 2020 Jan;29(1):e11-e21. doi: 10.1016/j.jse.2019.05.015. Epub 2019 Aug 9. PMID: 31405714.
  5. Xiros, Data on file

 

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