Evidence map›Paper›PMID 41549444›Full record

SynthesisThe American journal of sports medicine2026

Structural Augmentation in Rotator Cuff Repair Decreases the Risk of Retear: A Systematic Review and Meta-analysis.

Danielle Dagher, Darshil Shah, Colin Kruse, Hassaan Abdel Khalik, Usama Saleh, Abdul-Ilah Hachem, John M Tokish, Asheesh Bedi, Moin Khan

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in The American journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Danielle DagherDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-0372-8991
Darshil ShahDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Colin KruseDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-3871-1567
Hassaan Abdel KhalikDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-1711-515X
Usama SalehMedcare Orthopaedics and Spine Hospital, Dubai, United Arab Emirates.
Abdul-Ilah HachemDepartment of Orthopedic Surgery and Traumatology, University Hospital Bellvitge, Barcelona, Spain.
John M TokishDepartment of Orthopedic Surgery, Mayo Clinic, Scottsdale, Arizona, USA.
Asheesh BediDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Moin KhanDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-8237-8095

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRotator cuff tears are a common orthopaedic injury often resulting in shoulder pain and functional impairment. Despite the prevalence of rotator cuff tears, the incidence of retear after rotator cuff repair (RCR) remains high. There is growing interest in the use of structural augmentation in RCR to decrease retear rates and improve patient outcomes. PURPOSE: The purpose of this systematic review and meta-analysis was to compare the clinical and imaging outcomes of structural augmentation versus standard RCR in patients with full-thickness rotator cuff tears. The effectiveness of different augment subtypes was also assessed. STUDY

designMeta-analysis; Level of evidence, 3.

methodsA comprehensive literature search was conducted in CENTRAL, Embase, and Medline from inception to November 13, 2024. Eligible studies included comparative trials evaluating structural augmentation in RCR for repairable full-thickness tears. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized controlled trials and the MINORS (Methodological Index for Non-randomized Studies) score for observational studies. Meta-analyses were performed via a random effects model, with subgroup analyses performed by study design and augment type.

resultsTwenty-four studies (12 randomized controlled trials and 12 cohort studies) were included in this review, all of which evaluated biologic augments (xenograft, allograft, autograft). Structural augmentation significantly reduced the risk of retear by 35% as compared with standard RCR (risk ratio, 0.65; 95% CI, 0.48-0.89;

conclusionStructural augmentation in RCR significantly reduces retear rates, particularly with allografts, but does not improve short-term patient-reported outcomes. Further research is needed to identify which patient and tear characteristics may influence the effectiveness of augmentation.

Indexed as

ReinjuriesRotator Cuff InjuriesHumansRotator Cuffallograftaugmentationautograftrotator cuffsystematic reviewxenograft

Identifiers

PMID41549444
PMCPMC13133422

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.