Patrick DenardDirector Oregon Shoulder Fellowship, Oregon Shoulder Institute · Director Oregon Shoulder Fellowship at Oregon Shoulder Institute

Does my rotator cuff repair need augmentation?

13 Apr 2026 · 1 min

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In this video, the clinician explains how to determine whether a rotator cuff repair should be augmented with additional tissue. He outlines three primary risk factors for healing failure—nutritional status, tear size, and muscle quality—and notes that nutritional status may be the most critical. He introduces the Rotator Cuff Healing Index, a scoring system that assigns points for age, tear size, muscle quality, bone density, and activity level. This index facilitates a structured discussion with patients to decide on augmentation. In his practice, about 15–20% of patients receive augmentation alongside the standard rotator cuff repair.

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So how do I decide if augmentation of the rotator cuff is necessary? That means adding tissue to the rotator cuff. Well, first off, it's important to understand what are the risk factors. There's 3 big risk factors for failure of healing. We have nutritional status. Studies show that's actually maybe the most important factor. We have tear size and we have muscle quality. That is the muscle of the rotator cuff. Now most commonly what we do is use what's called a rotator cuff healing index that has points for multiple factors including age, tear size, muscle quality, bone density, activity. That allows me to create a scoring system and have a discussion with a patient and then make an informed decision about who is going to get augmentation. In my practice, that's typically 15 to 20% of my patients who have augmentation in addition to a rotator cuff repair.