Augmentation of rotator cuff repairs with biologic and structural grafts

Rotator cuff pathology is the most common cause of shoulder-related disability. With an aging population that becomes more active, the incidence of rotator cuff dysfunction is expected to increase. Numerous strategies have been developed to address the persistently high failure rates following rotator cuff repair. Among these are synthetic and biological patches, which can be used either to augment and reinforce a reparable tear or act as an interposition graft to bridge gaps in irreparable tears. This review examined the various augmentation techniques currently available and provided an in-depth analysis of the literature regarding the benefits and limitations of each. We found that these grafts offer mechanical support while incorporating biological materials that promote more natural enthesis healing without triggering an inflammatory response. Many studies have shown improved clinical and rotator cuff healing outcomes when compared to preoperative conditions. However, prospective randomized controlled trials are needed to identify the optimal graft source.