The Shoulder Research Program at the Cleveland Clinic involves two major areas of investigation. 1. Shoulder prosthetic design, performance, outcomes of surgery and the use of computer aided surgery. 2. Rotator cuff tear pathogenesis, tendon repair and reconstruction using tendon tissue engineering techniques.
The replacement of the arthritic and fractured shoulder joint has been developed as a regular practice over the last 50 years. Progress and improvements in the design of prosthetic components, the surgical technique and measurement of surgical outcomes is a programmatic area of research at the Cleveland Clinic. We study the design and performance of glenoid components with bone defects. Our studies are designed to develop new components that are able to improve the performance of the glenoid component in the setting of bone deficiency associated with arthritis and fractures care. We utilize computer modeling, FEA, biomechanical cadaver testing, rapid prototyping and clinical studies to optimize the design and use of novel glenoid components for the prosthetic reconstruction of the glenoid. We plan the adaptation of these techniques for the intra-operative computer navigation to enhance our ability to correct for glenoid bone loss for these novel component designs.
Using advanced 3D computer tomography to study glenoid bone loss, component position and loosening in a clinical patient population affords our surgical team the opportunity to evaluate existing and novel component and surgical techniques. At the present time we are developing the technology for computer aided glenoid insertion and preand post-operative 3D CAT scan imaging.
Rotator cuff tears are the most common cause of shoulder pain and disability. The ability of the rotator cuff tear to heal is limited due to the biologic properties of the tissue. Our laboratories are studying the biomechanical, histological and biochemical properties of tissue engineered tendon and graft materials in different rotator cuff defect animal models. We are also developing and testing new tissue engineered graft materials for rotator cuff repair.
Large chronic rotator cuff tears that are surgically repaired have a high chance that they will not heal. The degenerative changes of the tendon, the muscle atrophy and fatty fibrotic changes of the muscle impair the healing and rehabilitation of these tissues. Clinical trials are evaluating the clinical performance of some of the existing products in rotator cuff tears undergoing surgical repair. The biomechanical factors of tissue tension associated with muscle atrophy are being measured and evaluated for their effect on the healing of the repaired tendons.
