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

Document Type : SYSTEMATIC REVIEW

Authors

1 Conquest Hospital, East Sussex Healthcare NHS Trust, United Kingdom

2 Rowley Bristow Orthopaedic Unit, Ashford & St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey, United Kingdom

3 Rowley Bristow Orthopaedic Unit, Ashford & St Peter’s Hospitals NHS Foundation Trust, Chertsey, UK

4 University Hospitals Bristol and Weston NHS FT, Bristol UK Reading Shoulder Unit, Reading UK

5 University of Manchester (Undergraduate)

6 Ashford and St. Peter's Hospitals NHS Foundation Trust, St. Peter's Hospital, Guildford St, Lyne, Chertsey KT16 0PZ

7 Rowley Bristow Orthopaedic Unit, Chertsey, Surrey, United Kingdom Fortius Clinic, London

Abstract

Repair of large rotator cuff tears remains a challenging process with mixed success. There is growing interest over the use of patches to augment the repair construct and the potential this has to enhance its strength, healing and associated clinical outcomes. Such patches may be synthetic, xenograft or autograft/allograft, while 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. We explore the results of existing clinical trials for each graft type, as well as new manufacturing methods, novel techniques for biological enhancement and the histological and biomechanical impact of patch augmentation.

There are promising results in short term studies, which suggest that patch augmentation has great potential to improve success rates. In particular, this appears to be true of human dermal allograft, while porcine dermal grafts and some synthetic grafts have also had encouraging results. However, there remains a need for high quality, prospective clinical trials directly comparing each type of graft and the effect that they have on clinical and radiological outcomes of rotator cuff repair.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 15 February 2022
  • Receive Date: 06 December 2021
  • Revise Date: 09 January 2022
  • Accept Date: 17 January 2022
  • First Publish Date: 15 February 2022