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Arthroscopic Rotator Cuff Repair Using Absorbable Biologic Augment

February 19, 2016

Contributors: Russell Eric Holzgrefe, BS; Justin W Griffin, MD; Stephen F Brockmeier, MD; David Kovacevic, MD; David Kovacevic, MD

Rotator cuff tears affect more than 40% of individuals older than 60 years. For more than a decade, arthroscopic repair has been the standard treatment option for the management of rotator cuff tears. The rate of recurrent large to massive rotator cuff tears at a follow-up of 2 years is as high as 94%. Recent advances in repair techniques and surgical devices have decreased the reported incidence of recurrent rotator cuff tears to 9% to 12%. In total, 30% of primary and revision rotator cuff tears are considered irreparable. Promising initial results have been reported with the use of biologic augments in patients with a massive rotator cuff tear. In our recent, prospective multicenter study, arthroscopic rotator cuff repair via absorbable, biologic poly (4-hydroxybutyrate) augmentation was associated with excellent clinical outcomes based on validated scores and physical examination for motion and strength, resulting in an overall full-thickness retear rate of 4.4% at a follow-up of 1 year. This video demonstrates arthroscopic rotator cuff repair with the use of an absorbable biologic augment made of poly (4-hydroxybutyrate) in a 74-year-old man with a massive rotator cuff tear refractory to nonsurgical management.