Human dermal allograft augmentation in primary and revision arthroscopic rotator cuff repair: a retrospective controlled study including patient outcomes and ultrasound evaluation of tendon healing

Purpose: Rotator cuff (RC) tears are common in older adults, often leading to muscle atrophy. Standard arthroscopic repair has high re-tear rates, prompting the use of biological patches for augmentation. This study assessed differences in range of motion, strength, and tendon healing using ultrasound in primary and revision RC repairs using acellular dermal allograft augmentation. Methods: Forty-eight patients undergoing arthroscopic RC repair with dermal allograft augmentation were assessed, with 42 completing a median follow-up of 32.4 months. Twenty patients had primary repairs and 22 had revision procedures. A control group of 26 patients, matched for age, sex, BMI, and RC injury type, underwent RC repair without patch augmentation. Active range of motion, Constant-Murley socre (CS), Simple Shoulder Test (SST), Subjective Shoulder value (SSV) and isometric strength were measured. Tendon healing was assessed via dynamic US. Results: Both primary and revision groups showed significant improvements in clinical scores and shoulder mobility. However, the primary group had significantly higher postoperative CS, SST and SSV scores. Strength tests indicated lower values in the revision group compared to primary and control groups. Ultrasound outcomes showed reduced tendon thickness in 23 patients, with similar repair integrity across groups. Five cases of RC re-tears were noted, with higher but not significantly different re-tear rates in the revision group Conclusion : Dermal allograft augmentation in RC repair leads to significant clinical improvement in both primary and revision cases, but strength recovery is less pronounced in revision repairs. Long-term follow-up is necessary to validate these findings and assess the durability of tendon healing. Level of evidence: Level III, Retrospective cohort design, Treatment study