Patch Augmentation and Patch Extension for Complex Rotator Cuff Tears

The successful management of large to massive rotator cuff tears is challenging. Multiple factors to include poor tendon quality with fatty degeneration lead to high retear rates despite improved arthroscopic and open repair techniques. Patch augmentation and patch interposition with various grafts have been studied in an effort to both reinforce and bridge massive rotator cuff repairs, and provide an optimal biologic and mechanical environment at the tendon-bone interface. The purpose of this review is to present the current indications, surgical techniques, and outcomes of patch augmentation and patch interposition (extension) for large and massive rotator cuff tears.