A Comparison of Clinical Outcomes in Rotator Cuff Re-Tear Patients Who Had Either an Arthroscopic Primary Repair or Arthroscopic Patch Augmentation for Large-to-Massive Rotator Cuff Tears

Abstract

Background and Purpose: Despite the prevalent incidence of re-tear following rotator cuff repair, there is a notable lack of comparative studies investigating the outcomes between patients with re-tear who underwent primary repair versus those who received patch augmentation for large-to-massive tears. We assessed clinical outcomes of these techniques through a retrospective, randomized controlled trial. Methods: 134 patients diagnosed with large-to-massive rotator cuff tears from 2018 to 2021 underwent surgery; 65 had primary repair and 69 had patch augmentation. A total of 31 patients with re-tears were included, split into two groups; Group A (primary repair, 12 patients) and Group B (patch augmentation, 19 patients). Outcomes were evaluated using several clinical scales and MRI imaging. Results: Most clinical scores improved postoperatively in both groups. No significant difference in clinical outcomes was observed between groups, except for pain visual analog scale (P-VAS) scores. P-VAS scores showed greater decrease in the patch-augmentation group, a statistically significant difference. Conclusions: for large-to-massive rotator cuff tears, patch augmentation led to greater decreases in pain than primary repair, despite similar radiographic and clinical results. Greater tuberosity coverage of the supraspinatus tendon footprint may impact P-VAS scores.

Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair

“…They are composed of an acellular extracellular matrix (ECM), which is supposed to reduce the load on the repaired tendon so it can be protected during the healing phase and to induce native tissue to integrate by favoring vascularization and local cellular growth. Biomechanical studies [2,3] showed improvement in initial strength of the construct, as well as recent studies [21][22][23] that supported the clinical benefits of patch augmentation in rotator cuff repair, explained by the reduction in retear rate and pain.…”

Reinforcement Techniques in Arthroscopic Repair of Large-to-Massive Rotator Cuff Tears: A Comparative Study of Superior Capsule Reconstruction and Patch Graft Augmentation

“…Special care was taken to avoid strand tangling during this process (Figure 3). After positioning the allogeneic dermal patch underneath the patient's native rotator cuff tendon, the supraspinatus and infraspinatus muscles were augmented with strands that passed through the allogeneic dermal patch [13]. All ties were made using the Samsung Medical Center (SMC) knot technique [14].…”

“…After positioning the allogeneic dermal patch on top of the native rotator cuff tendon, the suture-bridge technique was used to fix the lateral side of the allogeneic dermal patch. Two or three lateral anchors were inserted depending on the size of the defect (Figure 6) [13]. After positioning the allogeneic dermal patch on top of the native rotator cuff tendon, the suture-bridge technique was used to fix the lateral side of the allogeneic dermal patch.…”

“…After positioning the allogeneic dermal patch on top of the native rotator cuff tendon, the suture-bridge technique was used to fix the lateral side of the allogeneic dermal patch. Two or three lateral anchors were inserted depending on the size of the defect (Figure 6) [13].…”

“…Three months postoperatively, patients were allowed to practice light sports activities. A full return to heavy labor or sports was allowed after six months depending on each patient's functional recovery [13].…”