Rotator Cuff Repair With Patch Augmentation: What Do We Know?



1 Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-On-Sea, UK

2 The Rowley Bristow Unit, Ashford and St. Peter’s NHS Trust, Chertsey, UK

3 3 East Kent Hospitals University NHS FT, Kent UK 4 Reading Shoulder Unit, Reading UK

4 University of Manchester, UK

5 The Rowley Bristow Unit, Ashford and St. Peter’s NHS Trust, Chertsey, UK- Smart Health Unit, University of East London, London, UK

6 The Rowley Bristow Unit, Ashford and St. Peter’s NHS Trust, Chertsey, UK- Fortius Clinic, London, UK


Background: Repair of massive rotator cuff tears remains a challenging process with mixed success. There is a
growing interest in the use of patches to augment the repair construct and the potential to enhance the strength,
healing, and associated clinical outcomes. Such patches may be synthetic, xenograft, or autograft/allograft, and a
variety of techniques have been tried to biologically enhance their integration and performance. The materials used are
rapidly advancing, as is our understanding of their effects on rotator cuff tissue. This article aims to evaluate what we
currently know about patch augmentation through a comprehensive review of the available literature.
Methods: We explore the results of existing clinical trials for each graft type, new manufacturing methods, novel
techniques for biological enhancement, and the histological and biomechanical impact of patch augmentation.
Results: There are promising results in short-term studies, which suggest that patch augmentation has great
potential to improve the success rate. In particular, this appears to be true for human dermal allograft, while porcine
dermal grafts and some synthetic grafts have also had promising results.
Conclusion: However, there remains a need for high-quality, prospective clinical trials directly comparing each type of
graft and the effect that they have on the clinical and radiological outcomes of rotator cuff repair.
Level of evidence: IV


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