Rotator Cuff Repair Augmentation

Rotator cuff repair (RCR) failure and retear remain a persistent problem and concern in shoulder surgery. Successful healing is paramount for long-term functional results. Failure of rotator cuff healing can be broadly separated into biologic and structural complications. Biologic issues include poor host variables such as healing ability and blood flow. Structural problems include tendon thinning and loss as well as poor time-zero fixation. Recently, commercial grafts or "patches" designed for rotator cuff augmentation have increased dramatically. Various grafts aim to enhance biology, provide structure, or both. In addition, grafts are designed to be placed either on-lay, over an RCR, or interpositional, at the bone-tendon interface. Graft may be allograft, xenograft, or fully synthetic. This article discusses the current RCR augmentation graft types and representative products currently available.