Enhanced Structural Outcomes With Acellular Dermal Matrix Patch Augmentation Versus Single-Row Repair in...

Although acellular dermal matrix (ADM) patch augmentation is known to reduce retear rates compared with repair without augmentation, clinical outcomes have varied across previous studies due to cohort heterogeneity.

ADM patch augmentation would lead to improved outcomes compared with single-row repair alone in a propensity score-matched cohort of patients with large-to-massive rotator cuff tear.

Cohort study; Level of evidence, 3.

This retrospective study investigated patients who underwent arthroscopic rotator cuff repair for large-to-massive posterosuperior tears between March 2019 and February 2024. Propensity score matching was performed to minimize selection bias, resulting in 32 patients each in the group that had single-row repair and the group that had single-row repair with ADM patch augmentation. Clinical outcomes and range of motion were compared at the 2-year follow-up. Structural integrity was assessed using magnetic resonance imaging at the 6-month follow-up. Multivariate logistic regression was conducted on the entire cohort to quantify the efficacy of patch augmentation in improving structural integrity.

After propensity matching, the baseline characteristics were similar between groups. Both groups demonstrated significant improvements in clinical outcomes and range of motion compared with preoperative status (all P < .001). Clinical outcomes and range of motion did not differ significantly between groups. However, the retear rate was significantly lower in the ADM patch augmentation group (12.5%) compared with the matched single-row repair group (34.4%; P = .039). In the multivariate analysis of the entire cohort of 160 patients, ADM patch augmentation showed reduced odds of retear compared with single-row repair alone (odds ratio, 0.292; P = .013).

In large-to-massive rotator cuff tears, ADM patch augmentation appeared to play a protective role in maintaining structural integrity. However, further studies are warranted to evaluate its long-term clinical outcomes.