Rotator cuff tears are a common cause of shoulder dysfunction, and their prevalence is difficult to quantify, ranging from 20.7% in a study of 683 subjects to 22% in 104 subjects aged 65 years and older. The main symptoms of rotator cuff tears are pain and limited mobility, and risk factors include advanced age and certain occupations. The treatment of rotator cuff tears includes non-surgical treatment and surgical treatment. Currently, surgical treatment is the primary treatment, and the repair technique is determined by the thickness, size, and shape of the tear, but the retear rate of conventional repair surgery is very high. In recent years, research on rotator cuff patches has led to new solutions, especially for patients with large rotator cuff tears, which promote healing of the tendon-bone interface and provide higher biomechanical stability. There are generally three types of mesh materials: heterogeneous mesh, allograft (allogeneic, autograft) , and synthetic mesh. Several studies have shown that these types of rotator cuff patches can improve clinical outcomes. There are still some controversies regarding the clinical efficacy of the rotator cuff patch and the possible inflammatory reaction. The research of rotator cuff patches is still a new technique in the repair of rotator cuff tears.

To investigate the controlled trials of rotator cuff patch or non-patch repair for rotator cuff injury in recent years and to perform a Meta-analysis of the therapeutic effect to provide a reference for selecting the appropriate surgical method; to review the research on rotator cuff patch in the past five years (2018-2022) , and to compare the differences between different patch types, to explore the clinical application scenarios of different patches, and to reveal the future research direction.

The relevant literature was screened in PubMed, Web of Science, and CNKI, the data were extracted, and a meta-analysis was performed with Revman 5.4 to compare the clinical outcomes of rotator cuff patch surgery and conventional repair surgery for systematic review.

A total of 9 articles were selected for Meta-analysis. Compared with the control group, the rotator cuff patch group had a significantly lower retear rate [OR = 0.18, 95% CI (0.09, 0.35) , P < 0.00001] ; there were no significant differences in visual analogue scale scores during follow-up at 0-12 months and more than 24 months (including 24 months) after surgery [MD = -0.28, 95% CI (-1.00, 0.44) , P = 0.45] , [MD = -1.72, 95% CI (-3.82, 0.37) , P = 0.11] ; Constant-Murley scores were significantly increased at 6 months and more than 24 months (including 24 months) after surgery [MD = 2.68, 95% CI (1.23, 4.13) , P = 0.0003] , [MD = 1.38, 95% CI (0.22, 2.54) , P = 0.02] . However, there was no significant difference in Constant-Murley scores during follow-up at 12 months after surgery [MD = 1.53, 95% CI (-1.74, 4.81) , P = 0.36] ; there was no significant difference in American shoulder and elbow surgeons scores during follow-up at 0-12 months and more than 24 months (including 24 months) after surgery [MD = 1.84, 95% CI (-1.60, 5.29) , P = 0.29] , [MD = 6.83, 95% CI (-0.10, 13.77) , P = 0.05] ; there was no significant difference in western ontario rotator cuff index during follow-up at 0-12 months after surgery [MD = 3.25, 95% CI (-15.45, 21.94) , P = 0.73] , but it increased significantly during follow-up at more than 24 months (including 24 months) after surgery [MD = 15.45, 95% CI (1.50, 29.34) , P = 0.03] ; postoperative shoulder flexion and external rotation were not significantly different [MD = 6.26, 95% CI (-9.52, 22.03) , P = 0.44] , [MD = -5.29, 95% CI (10.66, 0.08) , P = 0.05] .

Patch repair can improve the clinical outcome of rotator cuff tear repair and reduce the retear rate. The choice of patch type and surgical technique remains to be further investigated clinically.