Will This Patch Revolutionise Shoulder Surgery?

Researchers in Oxford University are perfecting a ‘smart patch’ that promises to improve shoulder surgery outcomes.

When implanted around damaged soft tissues, the patch creates an environment that expedites cellular healing.

This invention is being groomed to treat torn rotator cuffs, the group of tendons and muscles that hold the shoulder together. Orthopaedic surgeons have long complained about the tendency of tendons to disintegrate after surgical intervention.

If clinical trials, scheduled for 2015, prove successful, the patch would also be crucial to advancing surgical treatment of heart and bladder ailments as well as hernias and early arthritis.

This product will fetch around 1,500 pounds (AU$2,809), a comparative bargain relative to options like stem cell therapy.

Contemporary, antiquated

Lead researcher Andy Carr, Nuffield Professor of Orthopaedic Surgery at Oxford, drew from contemporary and antiquated technologies to develop the patch.

Its inner layer is a feat of nanotechnology: a web of fibres a hundredfold finer than human hair. This part of the patch mimics the ambience necessary for the regrowth of otherwise damaged cells.

These fragile fibres are protected from unnecessary movements by a second, thicker layer of strands. This layer is distinctive from the previous in that it is woven by hand, using a loom no less.

Both layers are built to degrade in the body within three to six months of implanting.

Around 10,000 rotator cuff surgeries are performed annually in the UK alone.

Kinds of shoulder surgery

Patients generally have two options in shoulder surgery: open surgery and arthroscopy.

In the former, the surgeon makes incisions of a few inches or so. Open surgery is indicated for extensive operations such as shoulder replacement.

The latter uses smaller incisions, just enough to make way for an arthroscope, a long, a pencil-thin instrument that holds a small camera. By relaying images to a monitor, this apparatus enables the surgeon to manipulate tiny devices that perform everything from tying knots to passing sutures to shaving tissues.

Arthroscopy can remove compromised ligaments, bone spurs, and cartilages (e.g. the labrum). After removal, these tissues may be replaced with anchors and other prosthetic material, a process called arthroplasty. In addition, surgeons use arthroscopes to facilitate such operations as cyst excisions and nerve release.

At best, arthroscopy takes no more than an hour and precludes hospitalisation; patients may resume work or school within a week.

Arthroscopic iincisions are closed with either stitches or steri-strips. Scarring may occur.

Aftermath

Everyone recovers from shoulder surgery at a different rate. Recovery depends as much on the patient’s resilience as the gravity of the ailment and may last up to several months.

Some degree of complications is to be expected in the wake of an operation. Pain, stiffness and swelling are the most immediate side effects, but patients should be wary of bleeding, numbness, fever, warmth, tenderness, and redness, for these could indicate an infection or damage to the nerves or blood vessels.

A prescriptive period of physiotherapy or rehabilitation almost always follows major procedures. Stretching and strengthening exercises, along with therapeutic interventions, are known to increase the success rates of surgeries.

Shoulder immobilisation is an absolute must after high-stakes operations. Patients should defer to the surgeon when it comes to the duration of wearing a sling or shoulder immobiliser.

Cells go on the mend speedily when movement is minimised, at least until the start of rehabilitation or physiotherapy. This is exactly the reason why those scientists invented the patch.