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Updated: Jun 16, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Rotator Cuff Repair Augmentation With an Autograft Biceps Patch, the "Biceps Smash," Results in Low Retear Rates at 6
Joseph C Brinkman1, M Lane Moore1, Casandra Smith1
1Department of Sports Medicine, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.
Purpose:
To evaluate retear rates, clinical outcomes, and complications of a consecutive series of full-thickness rotator cuff repair cases augmented with an autograft biceps patch.
Methods:
A retrospective review was performed of patients undergoing rotator cuff repair with autograft biceps patch augmentation. Patients underwent either magnetic resonance imaging or ultrasound to evaluate rotator cuff repair integrity at a minimum of 6 months postoperatively. Patient-reported outcomes including the American Shoulder and Elbow Surgeons Score and Single Assessment Numeric Evaluation score were also collected and evaluated for clinical significance at a minimum of 12 months postoperatively. Analysis of retear rates was performed by comparing observed retear rates to expected retear rates using the modified Rotator Cuff Healing Index score.
Results:
The final cohort included 25 rotator cuff repair cases. Postoperative imaging was obtained by magnetic resonance imaging in 22 patients at a mean of 9 months postoperatively (range, 6.0-15.3 months) and ultrasound in 3 patients at a mean of 30.4 months (range, 28.8-32.2 months). The expected retear rate using the modified Rotator Cuff Healing Index score was 21.5% for the entire cohort. There was 1 retear, resulting in an actual retear rate of 4% at an average of 23.5-month follow-up (P = .0196). The average Single Assessment Numeric Evaluation score was 93 (standard deviation 9), and the average American Shoulder and Elbow Surgeons Score was 96 (standard deviation 6.3) at an average of 23.5-month follow-up (range 14-32). Patient acceptable symptomatic state was achieved by 96% of the cohort for the American Shoulder and Elbow Surgeons Score and 88% of the cohort for the Single Assessment Numeric Evaluation score. There were no cases of reoperation or complications.
Conclusions:
In this consecutive series, the biceps autograft "smash" patch for rotator cuff augmentation resulted in a low rate of retears, favorable patient-reported outcomes, and no complications. This augmentation option has the potential to be safe and effective for improving rotator cuff repair healing rates.
Level Of Evidence:
Level IV, retrospective case series.
