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This case report describes the management of sequential rotator cuff (RC) tears with multiple patch graft augmentation in a polio-paraplegic athlete. The patient underwent these operations over a twenty-four year span from 1986-2010. The patient's case was complicated due to the fact he had more than a dozen upper extremity surgeries during this time period. The grafts used were autograft illiotibial band, followed by porcine xenografts, and finally allograft dermal collagen matrixes. This report describes the advancements in graft technology, and the surgical procedure associated with the grafts. After the most recent surgery, the patient exhibited full range of motion in both shoulders, the ability to perform independent transfers and was able to discontinue pain medication. Our case provides evidence of the success rate of using patch grafts in both frail tissue repairs as well as large cuff defects in a patient who places high demand on his upper extremities for daily activities.

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