Embody Post-Market Clinical Follow-Up Study

The proposed investigation is a multi-center, prospective patient registry: subscapularis repair augmented with TAPESTRY® Biointegrative Implant after shoulder arthroplasty. The primary objective of this study is to evaluate the long-term integrity of the subscapularis tendon repair after shoulder arthroplasty augmented with TAPESTRY Biointegrative Implant, assessed by ultrasound 6 months postoperatively. Secondary objectives are to assess shoulder function (internal rotation strength), safety, and patient reported outcomes. Patients will be evaluated preoperatively, at the time of surgery, 3, 6, 12 and 24 months after surgery. A total of 100 patients will be enrolled. Enrolled subjects will include adults undergoing shoulder arthroplasty, who meet the study eligibility criteria. The Tapestry Biointegrative Implant was FDA 510(k) cleared (K201572) on October 22, 2020, for the management and protection of tendon injuries in which there has been no substantial loss of tendon tissue. The primary analysis of subscapularis tendon repair integrity assessed by ultrasound will occur when all study subjects reach 6 months post-surgery. The goal of the analysis is to show that the tendon failure rate for subscapularis repair with Tapestry is lower than the failure rate for subscapularis repair without Tapestry a receiving surgery with the Tapestry and the literature-defined failure rate for tendon healing. Secondary endpoints will be analyzed when the last subject reaches the 24 month timepoint.

Inclusion criteria

• Adult, 21 years and older.
• Patient requires shoulder arthroplasty (anatomic or reverse) with subscapularis repair due to osteoarthritis, rotator cuff injury, rheumatoid arthritis and/or other inflammatory disorder, osteonecrosis, and/or post-traumatic injury (e.g., humerus fractures).
• Patients healthy enough to undergo primary anatomic or reverse shoulder arthroplasty, in the opinion of the investigator;
• Patients receiving shoulder arthroplasty with anticipated subscapularis tenotomy (ST) or subscapularis peel (SP).
• Intact rotator cuff including subscapularis tendon for anatomic shoulder arthroplasty or a repairable subscapularis tendon for reverse shoulder arthroplasty, as determined by preoperative examination or imaging, if indicated or available preoperatively. Imaging is not required for this assessment.
• Ability and willingness to comply with prescribed post-operative rehabilitation program.
• Ability and willingness to comply with follow-up visit schedule.
• Able to understand the informed consent process, including regulatory requirements such as HIPAA authorization, and document informed consent prior to completion of any study-related procedures.
• Ability to read, understand, and complete subject-reported outcomes in English.

Exclusion criteria

• Shoulder arthroplasty requiring a lesser tuberosity osteotomy or revision arthroplasty.
• Prior index shoulder surgery requiring treatment to the subscapularis.
• Intraoperative identification of irreparable subscapularis tear (rTSA)
• Diabetic patients with hemoglobin A1c (HbA1c) level >8% prior to surgery.
• Patients with inflammatory arthritis or patients that are immunocompromised, or patients that have a glenoid deficiency.
• Patients with a known history of hypersensitivity to bovine-derived materials.
• Hypersensitivity to poly(D,L-lactide) materials.
• Females of child-bearing potential who are pregnant or plan to become pregnant during the course of the study.
• Currently involved in any injury litigation or worker's compensation claims relating to the index shoulder.
• Enrolled, or plans to enroll, in another clinical trial during this study that would affect the outcomes of this study.
• History of non-compliance with medical treatment, physical therapy/rehabilitation, or clinical study participation.