• PURPOSE
    • The purpose of this study was to assess outcomes and complications of patch augmentation in the treatment of partial thickness rotator cuff tears (PTRCT).
  • METHODS
    • A systematic review was conducted identifying studies assessing outcomes following surgical treatment of PTRCT with patch augmentation and 6-month follow-up. Clinical studies with full-text manuscripts were identified using Embase, PubMed, Web of Science and Cochrane databases between January 1980 and December 2023. Postoperative tendon thickness on MRI was assessed as well as complications and reoperation rates. Forest plots and 95% confidence intervals were generated from mean differences (MD) in pre-post outcome data.
  • RESULTS
    • Seven studies met study criteria and only one study had a control group (one level III, six level IV). 514 total patients were enrolled. 482 utilized a bioinductive collagen patch. Of those, 446(93%) underwent debridement, and 36(7%) underwent take down and repair (TDR). 32 served as a control without augmentation, however only complications were assessed. 14(44%) underwent debridement alone and 18(56%) underwent TDR. American Shoulder and Elbow Surgeons (ASES) shoulder scores improved with MD ) of 16.9-41.3 in patients undergoing augmentation. The ASES shoulder function score improved with MD of 8.2-12.0. The ASES shoulder pain score improved with a MD of 3.5- 4.4. 83% to 93% of patients met a clinically important difference (MCID) in ASES scores at one year. 100% of patients with intermediate grade tears and 79.0% with high-grade tears met a MCID at two years. Tendon thickness increased ranging from 0.8 mm to 2.0 mm. Postoperative complication rates varied ranging from 3% to 25%. and reoperation rates ranging from 0% to 19%.. Reported complications varied;however stiffness/adhesive capsulitis was the most prevalent complication occurring in 0% to 25% of patients.
  • CONCLUSIONS
    • Augmentation was associated with increased tendon thickness and improved functional scores with 79% to 100% of patients meeting a MCID in outcome scores.
  • LEVEL OF EVIDENCE
    • Level IV, systematic review of Level III and IV studies.