A Pilot Assessment of Cryopreserved Umbilical Tissue Allograft as a Surgical Wrap for Improved Rehabilitative Outcomes in Peroneus Brevis Tendon Repair - Abstract
Surgical tendon repairs of the lower extremity are frequently associated with post-operative risks resulting in poor patient outcomes. Initially, pain levels contribute to extended lengths of post-operative rehabilitation while development of tissue adhesions and fibrosis limit long-term functionality through reduced range of motion. Several surgical methods describing incorporation of various augmentative graft materials in tendon repair exist. However, reports demonstrating technique and both short- and long-term patient outcomes are lacking. Recently, an advance in tissue-preservation technology has led to the commercialization of human placental allografts. Of these available allogeneic biomaterials, the components found in human placental membranes may provide anti-inflammatory, antimicrobial, anti-adhesive and antifibrotic properties to benefit surgical outcomes.
Here, the authors introduce and technically describe the use of a viable cryopreserved umbilical tissue (vCUT) (Stravix®, Osiris Therapeutics, Inc., Columbia, MD) as a complementary surgical wrap in primary tendon repair, with particular focus on the peroneus brevis, and report pilot study outcomes for post-operative pain, inflammation and scarring in 5 Achilles, peroneus brevis and tibialis posterior tendon repair cases using vCUT. Patients were evaluated by Visual Analog Scale (VAS) for pain both pre- and post-operatively. Transition times to CAM boot and normal shoewear with return to previous levels of activity were measured. All patients reported minimal to no pain at 1 week post-operatively and resumed previous levels of activity within 6-8 weeks, a result typically not observed until 3-6 months for historical control patients managed without adjunct vCUT in the literature. The results offer promise to improve rehabilitative outcomes for tendon repair patients.