 |
| The new drip-dry shirt material allows patient’s own tissue to grows in and around the patch. Most rotator-cuff tears are caused by repetitive overhead arm movement.
Swimming, weightlifting, painting and window cleaning can also increase
the likelihood of shoulder pain associated with poor rotator-cuff
function. |
Drip-dry shirt fabric patch cures torn shoulders: 40-minute op means end to chronic pain: A surgeon from Leeds, U.K. has invented a polyester drip-dry fabric patch that can seal ripped tendons to arm bones, transforming the treatment of shoulder injuries
A knitted patch made from drip-dry shirt material is being used to treat one of the most common causes of chronic pain. The polyester strip has revolutionised repairs to torn shoulder tendons. The patch, which was invented by surgeon and former Olympian runner Roger Hackney, is stitched over the muscle that allows the arm to raise in a speedy 40-minute operation.
Once in place, the patient’s own tissue grows in and around the patch to seal it permanently in place, and also to prevent any more tears. The simple op, which has been successfully carried out on around 50 patients during clinical trials at the Leeds Musculoskeletal Biomedical Research Unit, has now been approved for use in the UK and Europe.
Mr Hackney, a consultant orthopaedic surgeon at Spire Leeds Hospital, came up with the idea for the patch after becoming increasingly frustrated with not being able to offer patients an effective treatment for the repair of tears of the rotator cuff of the shoulder. "What to do with these patients was an unsolved surgical problem. It was awful having to tell them there was nothing else we could offer when they had lost the use of the shoulder, and were in severe pain," he said.
"These patients have considerable problems. They could not put their arm over their head, they had a shoulder that didn’t work, were in pain, particularly at night, and it affected their quality of life and their working life." The previous treatment patches were made from animal products and human skin and were difficult to use. Unsatisfied with the previous options Mr Hackney teamed up with Leeds-based Neoligaments, part of the medical device company Xiros, to develop and produce the patch.
 |
| Surgeon Roger Hackney designed the patch as he wasn't happy with the previous treatments. |
“One of the advantages of the new patch is that it can be used where no other repair can be achieved and the alternative treatments might give a poor outcome, so the patch is a great advance for this condition,” he said. Shoulder pain affects up to a quarter of adults at some time, with about 70 per cent due to rotator-cuff tears. And the prevalence increases with age, rising to three-quarters in those aged 70 and above, although in many cases it does not result in serious symptoms. The shoulder joint is a ball-and-shallow-socket assembly and is covered by the rotator cuff, a group of four muscles and their tendons which keep the joint stable and drive shoulder movement.
Most rotator-cuff tears are caused by repetitive overhead arm movement. Swimming, weightlifting, painting and window cleaning can also increase the likelihood of shoulder pain associated with poor rotator-cuff function. A tear occurs when the tendon comes away from the bone at the top of the arm. It can also be caused by trauma, such as a fall or dislocation.
 |
| The new drip-dry shirt fabric patch can fix torn tendons in a 40-minute operation. |
Symptoms of a tear include significant pain at night, with an inability to lie on the affected side, loss of overhead movement, muscle weakness and difficulty dressing and undressing. Where the tear is relatively small – less than 3cm – it can be surgically repaired by bringing the tendon to the bone, then stitching and anchoring the soft tissue of the cuff in place. But sometimes the tear is simply too large and stiff and cannot be stretched to the bone, making bigger tear repairs difficult.
Those greater than 5cm in diameter are not always repairable and gaps are left, leading to the tear returning with time. Mr Hackney's design is suitable for all types of tears. A key design feature is that its structure encourages growth of the patient’s own tissue into the patch material. Once inserted, it holds repaired tendons in place, alleviating pain and restoring movement. It also helps to prevent more tears. The patch is implanted using open surgery performed under general anaesthetic, and is stitched into place over a repair of the torn rotator cuff.
CASE STUDY
One of the first patients to benefit was Margaret Dyson, 53, who lives in Moortown, Leeds. The former teaching assistant had a patch implanted in her left shoulder at Spire Leeds Hospital in March and is now planning to have her right shoulder done. Margaret has suffered from rheumatoid arthritis for the past 20 years. The pain gradually increased over time until it became unbearable earlier this year.
“I was on a cocktail of painkillers and steroid injections but nothing would break the cycle of pain. I got to the stage where I could not lift my arm and the pain kept me awake so I only slept about every four nights when I became exhausted,” she said. Unable to lift her arm above her head, she couldn't perform simple tasks such as washing her hair or getting dressed without help from her husband, Louis. “I thought I would have to have a new shoulder so I was very happy to be offered this option,” said Margaret.
Soon after the procedure Margaret was feeling much better. “My arm was strapped in a sling for three weeks. After two weeks the pain had virtually gone. I can now sleep on my left side for the first time in months,” she added. Mr Hackney said: “Margaret's rheumatoid disease put her at an increased risk of failure of a normal repair, but using the patch allowed an early rehabilitation and rapid restoration of function with the expectation that she will regain full pain-free use of her shoulder.
Now, 10 weeks after surgery, Margaret says: “The post-op physio I’m receiving at Spire is fantastic and, as advised, I’m taking things slowly as my strength builds. "I’m really pleased with my range of movement and following the success of the surgery I’m looking forward to getting my other shoulder done. I would say it’s a miracle and would and advise anyone who is in a similar situation to find out more about this procedure!”
