• ABSTRACT
    • The estimated healthcare costs of failed arthroscopic RCRs performed in the United Statesrepresent a huge economic healthcare burden of greater than $400 million per two-year period. Unfortunately, retear rates do not appear to have improved significantly since the1980s, despite advances in surgical technology and the biomechanics of repair. The failure of these advances to translate into improved clinical results suggests that the limiting step inreducing retear rates is biology rather than the biomechanics of repair. Bioinductive collagen implants (BCIs) are an emerging and potentially useful option for biological augmentation. Recent meta-analysis of pre-clinical and clinical studies demonstrates that biological augmentation significantly lowers the risk of retear. Retrieval studies from human rotator cuff repair subjects who underwent treatment with BCI demonstrate cellular incorporation, tissue formation, and maturation providing a logical basis for reduction in retear rates as well as small increases in tendon thickness at the footprint. Although BCIs show potential as a possible game-changing solution for reducing failure rates of rotator cuff repair, concerns remain regarding cost effectiveness analyses and demonstration of functional outcome improvement.