Put a Patch on It!: When and How to Perform Soft-Tissue Augmentation in Rotator Cuff Surgery

Despite advancements in arthroscopic and surgical techniques, successful management of large to massive rotator cuff tears remains challenging. Risk factors including advanced age, significant retraction, reduced bone mineral density, and high physical demand have previously been shown to be negative prognostic indicators of good outcomes in rotator cuff repair. In order to increase healing rates, mechanical strength, and favorable biologic conditions, multiple patch augmentation and interposition techniques using tissue scaffolds have been developed. Numerous patch grafts are commercially available, including tissue scaffolds from autogenic, allogenic, synthetic, and xenogenic sources, although the quantity of literature varies widely between grafts. This review aims to present current indications, outcomes of patch interposition and augmentation, and surgical techniques for both primary and revision rotator cuff tears.