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Related Experiment Video

Updated: Nov 15, 2025

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Patch augmentation surgery for rotator cuff repair: the PARCS mixed-methods feasibility study.

Jonathan A Cook1, Mathew Baldwin1, Cushla Cooper1

  • 1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Health Technology Assessment (Winchester, England)
|March 1, 2021
PubMed
Summary

This feasibility study explored patch augmentation for rotator cuff surgery. Further research is needed to improve surgical outcomes and patient recovery, given the variety of patches available.

Keywords:
CONSENSUSCOST-BENEFIT ANALYSISDELPHI TECHNIQUEFEASIBILITY STUDIESFOCUS GROUPSMEDICAL DEVICEPATCHPATIENT-REPORTED OUTCOME MEASURESROTATOR CUFFSHOULDERSURGEONSSURVEYS AND QUESTIONNAIRES

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Clinical Trial Design

Background:

  • Rotator cuff tears are common and disabling shoulder problems, often requiring surgery with a high failure rate.
  • Patch augmentation (on-lay or bridging) shows promise for improving healing and patient outcomes in rotator cuff repair.
  • Various materials and processes are used for rotator cuff patches, necessitating further research into their effectiveness.

Purpose of the Study:

  • To determine the design of a definitive randomized controlled trial for patch-augmented rotator cuff surgery.
  • To assess the clinical and cost-effectiveness of rotator cuff repair augmentation using patches.
  • To ensure the trial design is acceptable to stakeholders and feasible for implementation.

Main Methods:

  • A mixed-methods feasibility study incorporating a systematic review and stakeholder engagement.
  • Systematic literature review (MEDLINE, EMBASE, Cochrane) from April 2006 to August 2018.
  • Stakeholder involvement through surveys, interviews, focus groups, Delphi study, and a consensus meeting.

Main Results:

  • Systematic review identified limited comparative evidence, with most studies at high risk of bias.
  • Surveys revealed a variety of patches in use and surgeon input on trial design.
  • Stakeholder consensus was reached on key research questions and potential trial designs.

Conclusions:

  • Further clinical studies are essential due to the range of available patches.
  • Randomized comparisons for on-lay and bridging patch use are recommended areas for research.
  • An observational study on patch safety is also highlighted as valuable.