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Related Experiment Video

Updated: Nov 15, 2025

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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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 summary is machine-generated.

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.