Augmentation of Arthroscopic Rotator Cuff Repair: Biologics and Grafts

  • Author Footnotes
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Caleb N. Morgan
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Eastern Virginia Medical School, Norfolk, VA, USA
    Search for articles by this author
  • Author Footnotes
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Kevin F. Bonner
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Eastern Virginia Medical School, Norfolk, VA, USA

    Jordan-Young Institute, 5716 Cleveland Street Suite #200, Virginia Beach, VA 23462, USA
    Search for articles by this author
  • Author Footnotes
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Justin W. Griffin
    Corresponding author.
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.
    Eastern Virginia Medical School, Norfolk, VA, USA

    Jordan-Young Institute, 5716 Cleveland Street Suite #200, Virginia Beach, VA 23462, USA
    Search for articles by this author
  • Author Footnotes
    1 Present address: 5716 Cleveland Street, Virginia Beach, VA 23462.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Clinics in Sports Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Molina C.S.
        • Thakore R.V.
        • Blumer A.
        • et al.
        Use of the national surgical quality improvement Program in orthopaedic surgery.
        Clin Orthop Relat Res. 2015; 473: 1574-1581
        • Novoa-Boldo A.
        • Gulotta L.V.
        Expectations following rotator cuff surgery.
        Curr Rev Musculoskelet Med. 2018; 11: 162-166
        • Park J.Y.
        • Lhee S.H.
        • Oh K.S.
        • et al.
        Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear.
        Arthroscopy. 2013; 29: 280-289
        • Yang Jr., J.
        • Robbins M.
        • Reilly J.
        • et al.
        The clinical effect of a rotator cuff retear: a meta-analysis of arthroscopic single-row and double-row repairs.
        Am J Sports Med. 2017; 45: 733-741
        • Hein J.
        • Reilly J.M.
        • Chae J.
        • et al.
        Retear rates after arthroscopic single-row, double-row, and suture bridge rotator cuff repair at a minimum of 1 year of imaging follow-up: a systematic review.
        Arthroscopy. 2015; 31: 2274-2281
        • Nho S.J.
        • Brown B.S.
        • Lyman S.
        • et al.
        Prospective analysis of arthroscopic rotator cuff repair: prognostic factors affecting clinical and ultrasound outcome.
        J Shoulder Elbow Surg. 2009; 18: 13-20
        • Boileau P.
        • Brassart N.
        • Watkinson D.J.
        • Carles M.
        • Hatzidakis A.M.
        • Krishnan S.G.
        Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal?.
        J Bone Joint Surg Am. 2005; 87: 1229-1240
        • Shin Y.K.
        • Ryu K.N.
        • Park J.S.
        • et al.
        Predictive Factors of retear in patients with repaired rotator cuff tear on shoulder MRI.
        AJR Am J Roentgenol. 2018; 210: 134-141
        • Yi J.W.
        • Cho N.S.
        • Cho S.H.
        • et al.
        Arthroscopic suture bridge repair technique for full thickness rotator cuff tear.
        Clin Orthop Surg. 2010; 2: 105-111
        • Meyer D.C.
        • Wieser K.
        • Farshad M.
        • et al.
        Retraction of supraspinatus muscle and tendon as predictors of success of rotator cuff repair.
        Am J Sports Med. 2012; 40: 2242-2247
        • Liem D.
        • Lichtenberg S.
        • Magosch P.
        • et al.
        Magnetic resonance imaging of arthroscopic supraspinatus tendon repair.
        J Bone Joint Surg Am. 2007; 89: 1770-1776
        • Garcia G.H.
        • Liu J.N.
        • Degen R.M.
        • et al.
        Higher critical shoulder angle increases the risk of retear after rotator cuff repair.
        J Shoulder Elbow Surg. 2017; 26 (published correction appears in J Shoulder Elbow Surg. 2017 Apr;26(4):732): 241-245
        • Chung S.W.
        • Oh J.H.
        • Gong H.S.
        • et al.
        Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors.
        Am J Sports Med. 2011; 39: 2099-2107
        • Abtahi A.M.
        • Granger E.K.
        • Tashjian R.Z.
        Factors affecting healing after arthroscopic rotator cuff repair.
        World J Orthop. 2015; 6: 211-220
        • Neyton L.
        • Godenèche A.
        • Nové-Josserand L.
        • et al.
        Arthroscopic suture-bridge repair for small to medium size supraspinatus tear: healing rate and retear pattern.
        Arthroscopy. 2013; 29: 10-17
        • Khair M.M.
        • Gulotta L.V.
        Treatment of irreparable rotator cuff tears.
        Curr Rev Musculoskelet Med. 2011; 4: 208-213
        • Abdel M.P.
        • Salib C.G.
        • Mara K.C.
        • et al.
        Extensor mechanism reconstruction with use of Marlex mesh.
        J Bone Jt Surg. 2018; 100: 1309-1318
        • Badhe S.P.
        • Lawrence T.M.
        • Smith F.D.
        • et al.
        An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears.
        J Shoulder Elbow Surg. 2008; 17: S35-S39
        • Chalmers P.N.
        • Frank R.M.
        • Gupta A.K.
        • et al.
        All-arthroscopic patch augmentation of a massive rotator cuff tear: surgical technique.
        Arthrosc Tech. 2013; 2: e447-e451
        • Barber F.A.
        • Burns J.P.
        • Deutsch A.
        • et al.
        A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair.
        Arthroscopy. 2012; 28: 8-15
        • Chalmers P.N.
        • Tashjian R.Z.
        Patch augmentation in rotator cuff repair.
        Curr Rev Musculoskelet Med. 2020; 13: 561-571
        • Derwin K.A.
        • Badylak S.F.
        • Steinmann S.P.
        • et al.
        Extracellular matrix scaffold devices for rotator cuff repair.
        J Shoulder Elbow Surg. 2010; 19: 467-476
        • Haque A.
        • Modi A.
        Interposition grafting for irreparable rotator cuff tears: Systematic review and specialist practice report.
        J Clin Orthop Trauma. 2021; 17: 218-222
        • Cai Y.Z.
        • Zhang C.
        • Jin R.L.
        • et al.
        Arthroscopic rotator cuff repair with graft augmentation of 3-dimensional biological collagen for moderate to large tears: a randomized controlled study.
        Am J Sports Med. 2018; 46: 1424-1431
        • Kim J.O.
        • Lee J.H.
        • Kim K.S.
        • et al.
        Rotator cuff bridging repair using acellular dermal matrix in large to massive rotator cuff tears: histologic and clinical analysis.
        J Shoulder Elbow Surg. 2017; 26: 1897-1907
        • Gilot G.J.
        • Alvarez-Pinzon A.M.
        • Barcksdale L.
        • et al.
        Outcome of large to massive rotator cuff tears repaired with and without extracellular matrix augmentation: a prospective comparative study.
        Arthroscopy. 2015; 31: 1459-1465
        • Bailey J.R.
        • Kim C.
        • Alentorn-Geli E.
        • et al.
        Rotator cuff matrix augmentation and interposition: a systematic review and meta-analysis.
        Am J Sports Med. 2019; 47: 1496-1506
        • Laskovski J.
        • Abrams J.
        • Bogdanovska A.
        • et al.
        Arthroscopic rotator cuff repair with allograft augmentation: making it simple.
        Arthrosc Tech. 2019; 8: e597-e603
        • Quigley R.
        • Verma N.
        • Evuarherhe Jr., A.
        • et al.
        Rotator cuff repair with graft augmentation improves function, decreases revisions, and is cost-effective.
        Arthroscopy. 2022; 38: 2166-2174
        • Flury M.
        • Rickenbacher D.
        • Jung C.
        • et al.
        Porcine dermis patch augmentation of supraspinatus tendon repairs: a pilot study assessing tendon integrity and shoulder function 2 years after arthroscopic repair in patients aged 60 years or older.
        Arthroscopy. 2018; 34: 24-37
        • Castagna A.
        • Cesari E.
        • Di Matteo B.
        • et al.
        Porcine dermal xenograft as augmentation in the treatment of large rotator cuff tears: clinical and magnetic resonance results at 2-year follow-up.
        Joints. 2018; 6: 135-140
        • Ferguson D.P.
        • Lewington M.R.
        • Smith T.D.
        • et al.
        Graft utilization in the augmentation of large-to-massive rotator cuff repairs: a systematic review.
        Am J Sports Med. 2016; 44: 2984-2992
        • Gillespie R.J.
        • Knapik D.M.
        • Akkus O.
        Biologic and Synthetic Grafts in the Reconstruction of Large to Massive Rotator Cuff Tears.
        J Am Acad Orthop Surg. 2016; 24: 823-828
        • Shepherd H.M.
        • Lam P.H.
        • Murrell G.A.
        Synthetic patch rotator cuff repair: a 10-year follow-up.
        Shoulder Elbow. 2014; 6: 35-39
        • Seker V.
        • Hackett L.
        • Lam P.H.
        • et al.
        Evaluating the outcomes of rotator cuff repairs with polytetrafluoroethylene patches for massive and irreparable rotator cuff tears with a minimum 2-year follow-up.
        Am J Sports Med. 2018; 46: 3155-3164
        • Ciampi P.
        • Scotti C.
        • Nonis A.
        • et al.
        The benefit of synthetic versus biological patch augmentation in the repair of posterosuperior massive rotator cuff tears: a 3-year follow-up study.
        Am J Sports Med. 2014; 42: 1169-1175
        • Cowling P.
        • Hackney R.
        • Dube B.
        • et al.
        The use of a synthetic shoulder patch for large and massive rotator cuff tears – a feasibility study.
        BMC Musculoskelet Disord. 2020; 21: 213
        • Mihata T.
        • Lee T.Q.
        • Watanabe C.
        • et al.
        Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears.
        Arthroscopy. 2013; 29: 459-470
        • Moroder P.
        • Akgün D.
        • Siegert P.
        • et al.
        Strings" (Multiple Tendon Interposition Autografts) for Reconstruction of Presumably Irreparable Rotator Cuff Tears.
        Arthrosc Tech. 2020; 9: e459-e467
        • Matthewson G.
        • Coady C.M.
        • Wong I.H.
        Rotator cuff reconstruction using fascia lata patch autograft for the nonrepairable rotator cuff tear.
        Arthrosc Tech. 2020; 9: e123-e130
        • Veen E.J.D.
        • Stevens M.
        • Diercks R.L.
        Biceps autograft augmentation for rotator cuff repair: a systematic review.
        Arthroscopy. 2018; 34: 1297-1305
        • Colbath G.
        • Murray A.
        • Siatkowski S.
        • et al.
        Autograft long head biceps tendon can be used as a scaffold for biologically augmenting rotator cuff repairs.
        Arthroscopy. 2022; 38: 38-48
        • Kim Y.S.
        • Lee H.J.
        • Park I.
        • et al.
        Arthroscopic in situ superior capsular reconstruction using the long head of the biceps tendon.
        Arthrosc Tech. 2018; 7: e97-e103
        • de Campos Azevedo C.I.
        • Ângelo A.C.L.P.G.
        • Vinga S.
        Arthroscopic superior capsular reconstruction with a minimally invasive harvested fascia lata autograft produces good clinical results.
        Orthop J Sports Med. 2018; 6 (2325967118808242)
        • Lacheta L.
        • Horan M.P.
        • Schairer W.W.
        Clinical and imaging outcomes after arthroscopic superior capsule reconstruction with human dermal allograft for irreparable posterosuperior rotator cuff tears: a minimum 2-year follow-up.
        Arthroscopy. 2020; 36: 1011-1019
        • LaBelle M.W.
        • Peck M.
        • Mengers S.
        Evaluating the role of graft integrity on outcomes: clinical and imaging results following superior capsular reconstruction.
        J Shoulder Elbow Surg. 2020; 29: e140-e141
        • Makovicka J.L.
        • Patel K.A.
        • Tokish J.M.
        Superior Capsular reconstruction with the addition of an acromial acellular dermal allograft spacer.
        Arthrosc Tech. 2018; 7: e1181-e1190
        • Griffin J.W.
        • Runzo D.
        • Bonner K.F.
        Arthroscopic biologic interpositional tuberosity graft for the treatment of irreparable rotator cuff tears.
        Arthrosc Tech. 2021; 10: e1729-e1735
        • Rodeo S.A.
        Biologic augmentation of rotator cuff tendon repair.
        J Shoulder Elbow Surg. 2007; 16: S191-S197
        • Galatz L.M.
        • Ball C.M.
        • Teefey S.A.
        • et al.
        The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears.
        J Bone Joint Surg Am. 2004; 86: 219-224
        • Li Z.
        • Zhang Y.
        Efficacy of bone marrow stimulation in arthroscopic repair of full thickness rotator cuff tears: a meta-analysis.
        J Orthop Surg Res. 2019; 14: 36
        • Steadman J.R.
        • Briggs K.K.
        • Rodrigo J.J.
        • et al.
        Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up.
        Arthroscopy. 2003; 19: 477-484
        • Chuckpaiwong B.
        • Berkson E.M.
        • Theodore G.H.
        Microfracture for osteochondral lesions of the ankle: outcome analysis and outcome predictors of 105 cases.
        Arthroscopy. 2008; 24: 106-112
        • Everts P.
        • Onishi K.
        • Jayaram P.
        • et al.
        Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020.
        Int J Mol Sci. 2020; 21: 7794
        • Filardo G.
        • Previtali D.
        • Napoli F.
        • et al.
        PRP injections for the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials.
        Cartilage. 2021; 13: 364S-375S
        • Mi B.
        • Liu G.
        • Zhou W.
        • et al.
        Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials.
        Phys Sportsmed. 2017; 45: 97-104
        • Kia C.
        • Baldino J.
        • Bell R.
        • et al.
        Platelet-rich plasma: review of current literature on its use for tendon and ligament pathology.
        Curr Rev Musculoskelet Med. 2018; 11: 566-572
        • Hurley E.T.
        • Lim Fat D.
        • Moran C.J.
        • et al.
        The efficacy of platelet-rich plasma and platelet-rich fibrin in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials.
        Am J Sports Med. 2019; 47: 753-761
        • Yang F.A.
        • Liao C.D.
        • Wu C.W.
        • et al.
        Effects of applying platelet-rich plasma during arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomised controlled trials.
        Sci Rep. 2020; 10: 17171
        • Ahmad Z.
        • Ang S.
        • Rushton N.
        • et al.
        Platelet-rich plasma augmentation of arthroscopic rotator cuff repair lowers retear rates and improves short-term postoperative functional outcome scores: a systematic review of meta-analyses.
        Arthrosc Sports Med Rehabil. 2022; 4: e823-e833
        • Vavken P.
        • Sadoghi P.
        • Palmer M.
        • et al.
        Platelet-rich plasma reduces retear rates after arthroscopic repair of small- and medium-sized rotator cuff tears but is not cost-effective.
        Am J Sports Med. 2015; 43: 3071-3076
        • Samuelson E.M.
        • Odum S.M.
        • Fleischli J.E.
        The Cost-effectiveness of using platelet-rich plasma during rotator cuff repair: a markov model analysis.
        Arthroscopy. 2016; 32: 1237-1244
        • Kim Y.S.
        • Lee H.J.
        • Ok J.H.
        • et al.
        Survivorship of implanted bone marrow-derived mesenchymal stem cells in acute rotator cuff tear.
        J Shoulder Elbow Surg. 2013; 22: 1037-1045
        • Hernigou P.
        • Flouzat Lachaniette C.H.
        • Delambre J.
        • et al.
        Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study.
        Int Orthop. 2014; 38: 1811-1818
        • Cole B.J.
        • Verma N.N.
        • Yanke A.B.
        • et al.
        Prospective randomized trial of biologic augmentation with mesenchymal stem cells in patientsundergoing arthroscopic rotator cuff repair.
        Orthop J Sports Med. 2019; 7 (2325967119S00275)
        • Jo C.H.
        • Chai J.W.
        • Jeong E.C.
        • et al.
        Intratendinous injection of autologous adipose tissue-derived mesenchymal stem cells for the treatment of rotator cuff disease: a first-in-human trial.
        Stem Cells. 2018; 36: 1441-1450