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The Oxford Biopatch is an innovative solution for rotator cuff repair which promotes rapid regrowth of tendon tissue and could transform the success of shoulder repair operations.

This type of injury will not kill you but it can seriously affect your quality of life. Patients are often in a lot of pain, with severely restricted movement. In some cases it can affect your livelihood and in older people it can affect independence. This will become more and more of a problem as the population ages and the retirement age is increased.
- Professor Andrew Carr

The rotator cuff is the group of tendons and muscles that control movement of the shoulder. Around a third of the population will suffer from should pain due to tendon disease at some time in their life, making it the third most common musculoskeletal complaint.

Developed by the Oxford Biopatch Group at the Botnar Research Centre, NDORMS, the patch is made of synthetic polymer and comprises two components with distinctive functions.

The first component is an electrospun layer, which provides physical cues to the repairing tissue by mimicking the natural environment of cells in our tissues and organs. The second component is a woven monofilament layer, which provide mechanical strength and suture retention properties to the patch.

Use

The patch will be used by surgeons to repair torn tendon tissue to bone and was designed by a multi-disciplinary team of surgeons, engineers and bio-chemists.

Collaborations

The project is a collaboration between Oxford University Hospitals NHS Trust and the University of Oxford, and is funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Unit and the Medical Research Council.

Background

More than 10,000 rotator cuff repairs are performed in the UK each year (more than 300,000 are performed in the US), and the group's own research has shown that between 25 and 50 per cent will fail to heal properly.

Professor Carr said the failure rate of surgery was due to the fact that the body was failing to repair properly after surgery. To improve the outcomes of surgery, the team have designed a material that mimics the normal environment that cells require in order to mount a successful repair.

He added: "The key to the new patch is creating a composite of two material layers. One layer is a very fine 'nanoscale' synthetic mesh that is recognised by cells and which promotes growth of new tissue. Our patch provides the physical cues needed for normal growth and development.

"However, because this fine mesh is relatively flimsy, a second woven layer of thicker strands is bonded to it to provide strength. This stronger layer means the scaffold can be sutured in position by a surgeon. It also protects the repair during the six to eight weeks required for tissue healing"

BENEFITS

The patch's scaffold degrades and is absorbed by the body after three to six months, leaving no foreign material in the long term.

With an expected price tag of less that £1,500, the new patch could offer effective treatment at a fraction of the cost of alternatives such as the use of stem cells or growth factors. Given the increasing number of operations being carried out, this will be a significant consideration.