In a pioneering step for South African medicine, the first shoulder cuff repair, using a brand-new biological implant option, is changing the course of rotator cuff repair procedures and healing.
The procedure uses the Regeneten® Bioinductive Implant, manufactured by Smith & Nephew, and was performed by orthopaedic surgeon Dr Will Haynes at Busamed Gateway in Umhlanga on compassionate grounds. Currently, the implant is only available in the US.
Rotator cuff disease is a significant and costly problem that causes ongoing pain and limits patients’ mobility. This disease is progressive, with small tears growing in size and severity over time, eventually requiring surgery. Up to 80% of partial-thickness tears increase in size within two years. When left untreated, rotator cuff tendinosis (a chronic condition involving deterioration of collagen in the tendons) can progress to a partial or full-thickness tear. Larger tears requiring surgery tend to re-tear over in over 40% of cases.
Innovation and intervention are as applicable to medicine as they are to any other field and thanks to this new implant, rotator cuff disease can now be treated biologically. According to Dr Haynes, the implant stimulates the body’s natural healing response to support new tendon growth and disrupt disease progression. It is derived from highly purified bovine Achilles tendon and creates an environment conducive to healing. It facilitates the formation of new tendon-like tissue, reducing the peak strain at the site of the tear. It gradually absorbs within six months and leaves a layer of new tendon-like tissue to biologically augment the existing tendon.
“This technology can be used in earlier stages of rotator cuff disease to slow progression of the condition. Addressing the injury earlier can shorten recovery time, reduce pain and improve quality of life. Intervening before a full tear has occurred may also decrease the chances of requiring traditional rotator cuff surgery. The technology can also be used in conjunction with traditional repair procedures to improve the tendon biology and decrease the chance of your rotator cuff tendon from re-tearing,” says Haynes.
After one year, 94% of patients were highly satisfied with their recovery. Recovery is rapid – an average of two to three days in a sling compared to 23 days from previous treatment protocols. What’s more, patients showed significantly improved ASES pain scores one year after surgery (ASES is a 100-point scale that measures pain and activities of daily living. It is a standardised shoulder assessment form developed by American shoulder and elbow surgeons).
Dr Diliza Mji, Busamed’s CEO says that the combination of optimal patient care and advances in medical technology are changing the face of surgery, resulting in better patient outcomes. “Previously, surgeons had limited ability to address rotator cuff injury at earlier stages of degeneration. In addition, traditional rotator cuff repair procedures resulted in long-term rehabilitation, significant lifestyle interruption and variable outcomes. As a result, many people delayed surgery, but as rotator cuff disease progresses, it can become increasingly more difficult to repair. We at Busamed are excited to partner with Dr Haynes and Smith & Nephew to be leading the advancement of health care in South Africa.”