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Related Experiment Video

Updated: Oct 23, 2025

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Findings from the patch augmented rotator cuff surgery (PARCS) feasibility study.

Jonathan A Cook1, Mathew Baldwin2, Cushla Cooper2

  • 1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. jonathan.cook@csm.ox.ac.uk.

Pilot and Feasibility Studies
|August 21, 2021
PubMed
Summary

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This summary is machine-generated.

Patch augmentation shows promise for rotator cuff surgery. A feasibility study explored designs for a definitive trial to assess patch effectiveness and cost-effectiveness, aiming to improve high failure rates in rotator cuff repair.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Clinical trial design

Background:

  • Rotator cuff tears are common, causing pain and disability, with high surgical failure rates.
  • Patch augmentation offers potential to support healing and improve outcomes in rotator cuff repair.
  • Limited clinical evidence exists for various patch materials and designs.

Purpose of the Study:

  • To determine the design of a definitive randomized controlled trial (RCT) for patch-augmented rotator cuff surgery (PARCS).
  • To assess the effectiveness and cost-effectiveness of patch augmentation.
  • To ensure the trial design is acceptable to stakeholders and feasible.

Main Methods:

  • A mixed-methods feasibility study involving a systematic review, surgeon surveys (BESS membership, trialists), stakeholder focus groups, and a Delphi study.
Keywords:
Dermal matrixFeasibility studyPatchRandomised trialRotator cuff tearShoulder surgerySurgical meshTissue scaffold

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  • Online questionnaires and a consensus meeting were used to gather and analyze data.
  • Six distinct stages were involved in the study's execution.
  • Main Results:

    • Surveys revealed diverse patch materials and designs currently in use.
    • Stakeholder input highlighted differing views on trial parameters, such as patient selection.
    • Agreement was reached on key research questions and potential RCT designs through the Delphi study and consensus meeting.

    Conclusions:

    • Further research is recommended for randomized comparisons of on-lay patches for complete repairs and bridging patches for partial repairs.
    • An observational study to evaluate safety concerns associated with patch use was also suggested.
    • Findings were influenced by participant perspectives, potentially not encompassing all stakeholder viewpoints.