{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:57:56Z","timestamp":1791568676260,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008542","name":"Arthroscopy Association of North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014413","name":"Ajinomoto Animal Nutrition North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014413","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the clinical outcomes of patients who underwent biologically enhanced patch augmentation repair for the treatment of revision massive rotator cuff tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010two patients who underwent arthroscopic and mini\u2010open rotator cuff repair using a patch augmented with platelet\u2010rich plasma and concentrated bone marrow aspirate (cBMA) for revision massive (\u22652 tendons) rotator cuff tears from 2009 to 2014, with a minimum 1\u2010year follow\u2010up, were included in the study. In this procedure the medial side of the graft is secured to the rotator cuff tendon remaining medially. American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test, and postoperative Single Assessment Numerical Evaluation scores were evaluated. To determine the clinical relevance of ASES scores, the minimal clinically important difference, substantial clinical benefit (SCB), and the patient\u2010acceptable symptomatic state (PASS) thresholds were used. Clinical success or failure was defined based on whether the patient reached the SCB threshold. In the\u00a0laboratory, cellular counting along with the concentration of connective tissue progenitor cells were performed on patch samples from the day of surgery. Scaffolds were processed histologically at days 0, 7,14, and 21 of culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients had significant improvement in the Simple Shoulder Test (2.6 \u00b1 3.0\n                      <jats:sub>pre<\/jats:sub>\n                      vs 5.2 \u00b1 4.2\n                      <jats:sub>post<\/jats:sub>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .01), whereas improvement in pain scores was found to be nonsignificant (5.6 \u00b1 2.5\n                      <jats:sub>pre<\/jats:sub>\n                      vs 4.2 \u00b1 3.4\n                      <jats:sub>post,<\/jats:sub>\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .11) at final follow\u2010up. Mean ASES improved by \u039414.6 \u00b1 33.4 points; however, this did not reach statistical significance (40.2 \u00b1 21.6\n                      <jats:sub>pre<\/jats:sub>\n                      vs 53.9 \u00b1\u00a031.4\n                      <jats:sub>post,<\/jats:sub>\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .10). With regards to ASES score, 45% of patients achieved the minimal clinically important difference, 41% the SCB, and 32% reached or exceeded the PASS criteria. At 21 days, there was a significantly greater cell count in scaffolds from patients who had clinical success than those who were failures (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Only 41% of patients undergoing biologically enhanced patch augmentation repair reached substantial clinical benefit, whereas 32% reached or exceeded the PASS criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Case Series: Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2020.02.006","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T17:09:29Z","timestamp":1585588169000},"page":"1542-1551","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":30,"title":["Clinical Outcomes Following Biologically Enhanced Patch Augmentation Repair as a Salvage Procedure for Revision Massive Rotator Cuff Tears"],"prefix":"10.1002","volume":"36","author":[{"given":"Lukas N.","family":"Muench","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery UConn Health Center Farmington Connecticut U.S.A."},{"name":"Department of Orthopaedic Sports Medicine Technical University of Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Kia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery UConn Health Center Farmington Connecticut 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