Background: Bone marrow stimulation (BMS) and patch augmentation (PA) are 2 adjuncts used during rotator cuff repair (RCR) to support the repair construct and promote healing. Purpose: To systematically review the literature to compare the clinical efficacy and retear rate outcomes of RCR with PA versus RCR with BMS. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review was conducted by searching the PubMed, the Cochrane Library, and Embase databases to identify Level 1 and 2 studies that compared the clinical efficacy of RCR alone with RCR plus BMS or RCR plus PA. The search phrase used was rotator cuff repair AND (patch OR augmentation OR bioinductive OR implant OR bone marrow stimulation OR microfracture OR crimson duvet OR BMS) . Patients were assessed based on the visual analog scale for pain, the Constant-Murley score, the American Shoulder and Elbow score, and retear rates. Results: Twenty studies (Level 1 or 2) met the inclusion and exclusion criteria, including 351 patients undergoing RCR with PA (mean age, 60 years) and 475 patients undergoing RCR with BMS (mean age, 59.9 years). The mean follow-up time was 20.6 months in the PA group and 21.1 months in the BMS group. None of the included studies directly compared PA and BMS, and there were no significant differences in weighted improvements among patient-reported outcomes from pre- to postoperative values between augmentation groups. Patients undergoing RCR with PA demonstrated no significant difference in retear rates at the latest follow-up compared with patients undergoing RCR with BMS. High heterogeneity among the included studies in the augmentation technique and tear grade was noted. Conclusion: Patients undergoing RCR with PA or BMS have demonstrated similar improvements in both patient-reported and functional outcomes. Further randomized controlled studies are needed to directly compare these 2 RCR augmentation groups, as well as compare different patch types and different BMS techniques.
Lim et al. (Fri,) studied this question.