Recent concepts in biological augmentation for rotator cuff tears: a scoping review.
5 affiliations
- 1Department of Orthopaedic Surgery, Cairo University, El Saray Street, Manial, Cairo, 11956, Egypt. [email protected].
- 2Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
- 3Department of Orthopaedic Surgery, Cairo University, El Saray Street, Manial, Cairo, 11956, Egypt.
- 4Orthopedic Research Network, Cairo University, Cairo, Egypt.
- 5Avicenna Medical College and Hospital, Lahore, Pakistan.
Abstract
Background
Surgical repair of rotator cuff tears is common, but failure rates remain a significant clinical challenge, particularly in large or degenerative tears. Augmentation strategies have been developed to enhance the biological and mechanical environment of the repair, aiming to improve healing and reduce retear rates.Aim
To provide a comprehensive scoping review of current biological augmentation strategies for rotator cuff repair, summarizing the underlying rationale, available materials, and recent clinical evidence to guide surgical decision-making.Methods
A systematic literature search was conducted and keywords related to rotator cuff repair and augmentation were used. Included studies investigated biological or combined biological and synthetic augmentation in human or animal subjects.Results
The search yielded 419 studies for qualitative synthesis. Augmentation techniques were categorized into allografts, xenografts, autografts, platelet-rich plasma (PRP), stem cells, non-tissue grafts, and other biological adjuncts. Human dermal allografts were the most frequently studied augmentation strategy and were associated with favorable healing and clinical outcomes in several studies. Autografts, such as fascia lata and the long head of the biceps tendon, have emerged as promising alternatives with favorable biocompatibility. Evidence for PRP and stem cells remains inconsistent, with no universal consensus on preparation and application techniques. Non-tissue synthetic grafts offer mechanical support but lack long-term data.Conclusion
Augmentation provides a valuable tool for improving healing in high-risk rotator cuff repairs. Human dermal allografts and autografts are supported by the strongest and largest amount of current evidence. However, no single strategy is universally superior. Future research should focus on large-scale, standardized comparative trials and combinatory approaches that merge structural support with targeted biologic enhancement.
Related
- Biological Augmentation of Arthroscopic Partial‐Thickness Bursal‐Sided Rotator Cuff Repair Using Minced Autologous Glenohumeral Ligament Tissue Particles
- “The box” allograft augmentation for at risk rotator cuff repairs
- Surgical Technique for Arthroscopic Rotator Cuff Repair With All-Polyester Patch Augmentation.
- Arthroscopic “Triple‐Beam” Biologic Augmentation of Massive Rotator Cuff Tears Using the Combined Long Head of Biceps Transposition and Autologous Palmaris Longus Tendon Bridging
- pADM patch augmentation for rotator cuff repair: In vivo safety and efficacy in a canine model.
BibTeX
@article{sabry2026recent,
title = {{Recent concepts in biological augmentation for rotator cuff tears: a scoping review.}},
author = {Ahmed O Sabry and Khaled A Elmenawi and Sherif Ibrahim and Cole Johnson and Amr Hesham Kamel Abdelgawad and Abdelrahman Hussein and Nada G Hamam and Rizwan Latif and Merna Arid and Yasser Elsafoury},
journal = {BMC musculoskeletal disorders},
year = {2026},
month = oct,
doi = {10.1186/s12891-026-10436-5},
url = {https://europepmc.org/article/MED/42963566},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Recent concepts in biological augmentation for rotator cuff tears: a scoping review.
AU - Ahmed O Sabry
AU - Khaled A Elmenawi
AU - Sherif Ibrahim
AU - Cole Johnson
AU - Amr Hesham Kamel Abdelgawad
AU - Abdelrahman Hussein
AU - Nada G Hamam
AU - Rizwan Latif
AU - Merna Arid
AU - Yasser Elsafoury
PY - 2026
DA - 2026/10/17
JO - BMC musculoskeletal disorders
DO - 10.1186/s12891-026-10436-5
UR - https://europepmc.org/article/MED/42963566
AB - Background Surgical repair of rotator cuff tears is common, but failure rates remain a significant clinical challenge, particularly in large or degenerative tears. Augmentation strategies have been developed to enhance the biological and mechanical environment of the repair, aiming to improve healing and reduce retear rates.Aim To provide a comprehensive scoping review of current biological augmentation strategies for rotator cuff repair, summarizing the underlying rationale, available materials, and recent clinical evidence to guide surgical decision-making.Methods A systematic literature search was conducted and keywords related to rotator cuff repair and augmentation were used. Included studies investigated biological or combined biological and synthetic augmentation in human or animal subjects.Results The search yielded 419 studies for qualitative synthesis. Augmentation techniques were categorized into allografts, xenografts, autografts, platelet-rich plasma (PRP), stem cells, non-tissue grafts, and other biological adjuncts. Human dermal allografts were the most frequently studied augmentation strategy and were associated with favorable healing and clinical outcomes in several studies. Autografts, such as fascia lata and the long head of the biceps tendon, have emerged as promising alternatives with favorable biocompatibility. Evidence for PRP and stem cells remains inconsistent, with no universal consensus on preparation and application techniques. Non-tissue synthetic grafts offer mechanical support but lack long-term data.Conclusion Augmentation provides a valuable tool for improving healing in high-risk rotator cuff repairs. Human dermal allografts and autografts are supported by the strongest and largest amount of current evidence. However, no single strategy is universally superior. Future research should focus on large-scale, standardized comparative trials and combinatory approaches that merge structural support with targeted biologic enhancement.
SN - 1471-2474
ER -