Related Experiment Video
Updated: Sep 19, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Rotator cuff tendon augmentation and inter-user reproducibility assessment of a novel patch fixation technique
Bettina Hochreiter1, Ronja Senn2, Carmen Castroviejo1
1Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Background:
Rotator cuff (RC) tears present a major socioeconomic burden with high rates of retear after repair surgery. The interlocked patch augmentation represents a novel approach using direct fiber interlocking of a nonwoven polyethylene terephthalate patch into tendon tissue. This study evaluated the biomechanical strength and properties of human cadaveric RC augmentation with direct patch interlocking and its reproducibility.
Methods:
Two complementary studies were conducted: (1) a biomechanical human cadaver study on paired infraspinatus tendons comparing 2 horizontal mattress stitches with and without interlocked patch augmentation (n = 5 per group) measuring cyclic loading and load-to-failure testing; (2) a user performance reproducibility evaluation with 6 orthopedic surgeons (first-time users group) and 3 interlocked patch augmentation experts (control group), each performing 4 arthroscopic procedures using ovine infraspinatus tendons.
Results:
In the human cadaver study, direct patch interlocking demonstrated significantly higher ultimate tensile strength and linear stiffness compared with the nonaugmented group (519.4 ± 150.8 N vs. 294.6 ± 84.1 N; P = .0195 and 44.7 ± 13.2 N/mm vs. 21.2 ± 6.4 N/mm; P = .0016). Cyclic stiffness and elongation did not show significant differences. In the user performance study, no significant difference in ultimate tensile strength was found between first-time users (392.1 ± 62.1 N) and experts (322.6 ± 86.3 N, P = .0991). Inter-user comparison among surgeons showed no significant differences (P = .4830).
Conclusion:
The interlocked patch augmentation significantly improves biomechanical suture retention properties in a human cadaveric RC model and enables reproducible outcomes when used by orthopedic surgeons without prior device training. These preliminary biomechanical findings support further evaluation of direct patch interlocking for RC repair augmentation in further biomechanical and clinical studies.
