Prospective comparative study of arthroscopic rotator cuff repair with or without acellular dermal matrix augmentation: clinical and radiological outcomes

Objective: To prospectively evaluate the safety and effectiveness of arthroscopic acellular dermal matrix (ADM) augmentation of large rotator cuff tear repairs (RCR) in a comparative study.

Methods: A prospective single-center series of 20 patients undergoing arthroscopic RCR. The patients were randomized to arthroscopic transosseous-equivalent rotator cuff patch augmentation repair with a decellularized dermis prepared in the tissue bank or a control group without augmentation. Preoperative and postoperative functional outcomes were assessed by The University of California-Los Angeles (UCLA) score. Magnetic resonance imaging (MRI) evaluation was obtained 1 year after surgery. All adverse events were recorded. Statistical analysis was performed in R 4.2 (Boston, USA), using non-parametric group tests for paired data to evaluate functional results. The mean age was 59 years in the ADM group and 56.7 years in the control group. The gender distribution was 60% male and 40% female in both groups.

Results: Each group consisted of 10 patients, with no statistically significant differences observed in age, body mass index, or preoperative UCLA assessment. In the ADM augmentation group, 2 patients required reoperation due to re-tear before the end of the follow-up period. No statistically significant differences were found in functional outcome measures at any of the evaluation points. Final MRI identified 5 reruptures in the matrix group and 6 in the control group, showing no statistical difference between groups. No adverse events attribut able to the presence of the grafts were detected.

Conclusion: These findings suggest that ADM augmentation may yield outcomes comparable to standard care, in terms of UCLA scores and re-tear rates. No adverse events related to ADM were observed.

Cite this article as: Sastre S, Pérez ML, Postnikov Y, et al. Prospective comparative study of arthroscopic rotator cuff repair with or without acellular dermal matrix augmentation: clinical and radiological outcomes. Acta Orthop Traumatol Turc., Published online November 7, 2025. doi:10.5152/j.aott.2025.24189.