Rotator Cuff Matrix Augmentation and Interposition: A Systematic Review and Meta-analysis

Abstract

In the meta-analysis, graft augmentation or interposition appeared to provide a lower retear rate and improved ASES scores when compared with RCR alone. Future prospective, randomized, controlled, and appropriately powered trials are needed for more definitive recommendations.

Rotator Cuff Tears : Short- and long-term aspects on treatment outcome

“…As has been reviewed in the background section (Grafts and patches in rotator cuff surgery, pp. 37-38), a positive effect on retear rates and clinical scores has been found, even if this is based on few studies and a low level of evidence 14 .…”

“…Grafts and patches are mainly used for bridging a defect caused by an irreparable cuff tear (interposition grafts) or for augmentation, in which the tendon is repaired and the graft is put on top of the repair to reinforce and protect the repair site 14 . Tissue grafts can be autologous (for example fascia lata or long head of biceps), allografts (for example fascia lata, human dermal tissue, periosteum) and xenografts (for example porcine dermal or intestinal submucosal grafts).…”

“…The rates of retears after cuff repair are highly variable, with rates ranging from 11 % 158 to 94 % 90 in the literature. The rationale for using grafts and patches as augmentation is to reinforce a cuff repair, adding mechanical strength and a more protective environment 14 . In a clinical setting the most common scenario for patch augmentation is probably in revision cases where a new repair is possible, but the surgeon feels the need to add something more than what was done in the previous operation.…”

“…In a clinical setting the most common scenario for patch augmentation is probably in revision cases where a new repair is possible, but the surgeon feels the need to add something more than what was done in the previous operation. In a meta-analysis, summarizing the results from 5 studies regarding retear rates, a 61 % lower odds of a retear was found when pooling the results for augmentation grafts 14 . A better effect of augmentation on the ASES score was also shown, but not for the UCLA-score or pain 14 .…”

“…In a meta-analysis, summarizing the results from 5 studies regarding retear rates, a 61 % lower odds of a retear was found when pooling the results for augmentation grafts 14 . A better effect of augmentation on the ASES score was also shown, but not for the UCLA-score or pain 14 . Overall, the level of evidence is low and there are too few studies to make solid conclusions in this area.…”