Arthroscopic Single-Row Rotator Cuff Repair Augmentation With Interpositional Demineralized Bone Fiber Implant

Although biomechanical studies show increased load to failure and less gap formation with double-row rotator cuff repair, clinical outcome scores do not necessarily favor double-row rotator cuff repair over single-row repair. Some studies report higher retear rates with single-row repair versus double-row repair, especially with larger tears, but these results do not include orthobiologic augmentation. Single-row repairs with multiple sutures, emphasizing biologic augmentation by venting the proximal humerus, show excellent healing rates and patient satisfaction. Although much of the rotator cuff biologic augmentation literature focuses on scaffolds placed over the cuff, demineralized bone matrix scaffolds at the footprint can promote enhanced healing at the enthesis. This technical note describes a single-row technique that uses demineralized bone fiber scaffolds to augment rotator cuff biologic healing at the enthesis.