A clinician explains when rotator cuff repairs need reinforcement with extra tissue. Three main risk factors predict healing failure: nutrition, tear size, and muscle quality. He uses the Rotator Cuff Healing Index to score patients and decide on augmentation, which about 15-20% of his patients receive.
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.
