AANA19 Shoulder Access Pass-Discussion and Request for Proposal Definition-Dr. Brian J. Cole, M.D., M.B.A.

Discussion and Request for Proposal Definition-Dr. Brian J. Cole, M.D., M.B.A.

Video Transcription

Video Summary

The discussion centers on rotator cuff repair challenges, focusing on the complex tendon-to-bone interface and the role of the enthesis in healing. Experts note current methods don't fully restore the natural interface, and emphasize the importance of immune and inflammatory environments, cellular sources like the bursa, and mechanical loading in repair. They discuss potential therapies including vitamin D, doxycycline, MMP inhibitors, and rapamycin, but caution that single-factor treatments may be insufficient. Ongoing studies include cell-based treatments and randomized trials of biologic injections, with early promising but inconclusive results. The need to address tendon quality and molecular inflammation, especially related to metabolic conditions, is highlighted.

Keywords

rotator cuff repair

tendon-to-bone interface

enthesis healing

immune and inflammatory environment

cell-based therapies