Rotator cuff tears affect 40% or more of people over the age of 60 and cause debilitating pain, reduced function and weakness in the shoulder. In excess of 250,000 rotator cuff repairs are performed annually in the United States. Despite improvements in our understanding of this disease process and advances in surgical treatment, healing following rotator cuff repair remains a significant clinical challenge and repair failure rates of 20-70% continue to be reported.
Further, abdominal wall hernias complicate nearly one-third of all abdominal surgeries, and an estimated 350,000 hernia repairs costing a total of US $3.2 billion are performed each year in the United States alone. However, repair outcomes are poor, with 24-43% of hernia repairs resulting in repair failure and hernia recurrence. It is estimated that just 1% reduction in recurrence rate will result in a cost saving of US $32 million.
Both of these clinical problems require a strategy for improving musculoskeletal soft tissue repair. Various synthetic and biologic materials have been used as repair augmentation scaffolds for these conditions, but have demonstrated limited success to date. To address this need,the Derwin Laboratory hasbeen developing novel, composite scaffolds derived from biologic and syntheticmaterials. These scaffolds have shown promise for improving rotator cuff repair in laboratory research, and are now ready to be tested in human trials. Laboratory research on these scaffolds for abdominal wall repair is ongoing. In the future we expect to adapt these composite scaffolds for application in skin, craniomaxillofacial and genitourinary soft tissue regeneration.
In other words ...
Our research program aims to (1) develop biomaterial patches to improve healing and outcomes of soft tissue repairs such as, for example, repair of the tendons in the shoulder or hernias in the abdominal wall; (2) understand why rotator cuff muscles get fatty and smaller after rotator cuff injury and develop ways to limit or reverse this process; and (3) develop non-invasive methods to monitor the integrity and quality of healing soft tissue repairs.
- Sahoo S, Delozier KR, Erdemir A, Derwin KA. Clinically relevant mechanical testing of hernia graft constructs. J Mech Behav Biomed Mater 41:177-88 (2015) doi: 10.1016/j.jmbbm.2014.10.011
- Sahoo S, Delozier KR, Dumm RA, Rosen MJ, Derwin KA. Fiber-reinforced dermis graft for ventral hernia repair. J Mech Behav Biomed Mater, 34:320-9 (2014) doi: 10.1016/j.jmbbm.2014.03.001
- Ma J, Sahoo S, Baker AR, Derwin KA. Investigating Muscle Regeneration with a Dermis/Small Intestinal Submucosa (SIS) Scaffold in a Rat Full-Thickness Abdominal Wall Defect Model. J Biomed Mater Res B – Applied Biomaterials (2014) doi: 10.1002/jbm.b.33166
- Mesiha MM, Derwin KA, Sibole SC, Erdemir A, McCarron JA: The biomechanical relevance of rotator cable tears in a cadaveric shoulder model. J Bone Joint Surg Am, 2013 Oct 16;95(20):1817-1824. doi: 10.2106/JBJS.L.00784
- McCarron, JA, Milks, RA, Mesiha, M, Aurora, A, Walker, E, Iannotti, JP, Derwin, KA. Reinforced fascia patch limits cyclic gapping of rotator cuff repairs in a human cadaveric model. J Shoulder Elbow Surg. (2012). PMID: 22361715.
- Leigh DR, Kim MS, Kovacevic D, Baker AR, Tan CD, Calabro A, Derwin KA: Human fascia lata ECM augmented with immobilized hyaluronan: host response in the canine shoulder and body wall implantation sites. J Biomater Sci Polym Ed (2015).
|US Patent||Patent Title||Issue Date||First-Named Inventor|
|8,080,260||Molecular Enhancement of Extracellular Matrix and Methods of Use||12/20/2011||Kathleen Derwin Ph.D.|
Kurt Spindler, MD, co-director of Cleveland Clinic’s Musculoskeletal Research Center, was awarded a five-year, $6 million grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases to study techniques used for anterior cruciate ligament (ACL) reconstruction.