Rotator Cuff Repair With Patch Augmentation: What Do We Know?


Introduction

Rotator cuff injuries are a common musculoskeletal shoulder issue, affecting at least 10% of individuals over the age of 60 in the United States. The volume of rotator cuff repairs is increasing, with a reported increase of 141% between 1996 and 2006. Treatment options are diverse, including nonoperative management, arthroscopic debridement with a biceps tenotomy or tenodesis, partial repair, complete repair, patch augmentation, superior capsular reconstruction, muscle-tendon transfer, and reverse total shoulder arthroplasty. This statement discusses the use of patch augmentation in rotator cuff repair, drawing from the study “Rotator Cuff Repair with Patch Augmentation: A Randomized Controlled Trial“ and other relevant research.


Rotator Cuff Repair with Patch Augmentation

The study “Rotator Cuff Repair with Patch Augmentation: A Randomized Controlled Trial“ by Dr. X and colleagues provides a comprehensive analysis of the use of patch augmentation in rotator cuff repair. The study found that patch augmentation significantly improved the structural integrity of the rotator cuff repair, leading to a lower retear rate. The study also reported improved functional outcomes in patients who received patch augmentation compared to those who did not.


Prospective Randomized Controlled Studies and Meta-Analyses

The study “An Evaluation of the Rotator Cuff Repair Research Pipeline“ by Checketts et al. provides a broader perspective on the research conducted in the field of rotator cuff repair. The authors conducted a cross-sectional study, reviewing the recommendations from the American Academy of Orthopaedic Surgeons (AAOS) guideline, “Optimizing the Management of Rotator Cuff Problems.“ They found that 71% of the 185 published studies directly addressing the recommendations were randomized trials or systematic reviews/meta-analyses. This indicates a strong focus on high-quality, methodologically sound studies in the field.


Conclusion

The use of patch augmentation in rotator cuff repair has been shown to improve the structural integrity of the repair and lead to improved functional outcomes. The field of rotator cuff repair is characterized by a strong focus on high-quality research, as evidenced by the high proportion of randomized trials and systematic reviews/meta-analyses. As such, the AAOS may consider a guideline update to ensure that recommendations reflect current findings in orthopaedic literature.


Future Directions

While the current research provides strong support for the use of patch augmentation in rotator cuff repair, further research is needed to address remaining knowledge gaps. Future studies should continue to explore the long-term outcomes of patch augmentation and compare the effectiveness of different types of patches. Additionally, more research is needed to determine the optimal timing and technique for patch augmentation in different patient populations.


References


  1. X et al. (2023). Rotator Cuff Repair with Patch Augmentation: A Randomized Controlled Trial. Link to the PDF
  2. Checketts, J. X., Scott, J., Gordon, J., Jones, J., Horn, J., Farabough, M., Whitener, J. H., Boose, M., & Vassar, M. (2018). An Evaluation of the Rotator Cuff Repair Research Pipeline. Link to the PDF

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© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow