JAAOS - 2026-05-15 - Journal Article; Review
Rotator Cuff Repair Augmentation.
Huff SW, Haislup BD, Murthi AM
Topics
Key Takeaway
Retear rates of 5–50% after rotator cuff repair have driven rapid commercial expansion of augmentation grafts, which are categorized by material (allograft, xenograft, synthetic) and placement (onlay vs. interpositional) to address biologic or structural failure modes.
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Summary
This JAAOS review addresses the problem of rotator cuff repair failure by cataloguing currently available commercial augmentation grafts. Grafts are classified by material type (allograft, xenograft, synthetic) and surgical placement (onlay over repair vs. interpositional at bone-tendon interface), with each category targeting biologic enhancement, structural reinforcement, or both. No original data or pooled outcomes are reported; the article is a descriptive taxonomy of available products.
Key Limitation
No clinical outcome data, comparative trials, or evidence-quality assessment are included, making it impossible to determine whether any augmentation strategy meaningfully reduces retear rates.
Original Abstract
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.