Arthroscopic Rotator Cuff Repair With Collagen Patch Augmentation: An In Vivo Examination of Biologic and Biomechanical Patches.

The use of patch augmentation in the setting of large-to-massive rotator cuff repairs and poor tissue quality may reinforce native tissue and add structural integrity, potentially decreasing retear rates. Many patches are currently marketed for this use, with research focusing primarily on easily observable surgical outcomes, including range of motion, pain, and functionality. These case reports investigate the use of two such patches, Regeneten (Smith+Nephew, Andover, MA, USA) and BioBrace ( CONMED, New Haven, CT, USA), observed at subsequent revision surgeries; this in vivo observation provides insight into the cellular effects of these patches, namely, the extent of healing and tissue proliferation. In case 1, Patient A received a Regeneten patch during initial repair; upon revision nine months later, staple fragments were found floating in the joint space, with no evidence of the previously placed patch except for bone anchors. In case 2, Patient B received a BioBrace patch during initial repair; upon revision five months later, the patch was found to be intact and well-integrated, with evidence of cellular overgrowth and neovascularity. These two cases, each a single point-in-time evaluation of a prior rotator cuff repair with patch augmentation, raise questions regarding a potential difference in the bioinductive properties of the two patches. Further large-scale studies are warranted to investigate the different bioinductive qualities of the patches and their role in the cellular healing process, as well as their unique complication risks.