Bridging Reconstruction Using a Biocomposite Scaffold for Large/Massive Rotator Cuff Tears: A Technique Guide.

Given the proposed mechanism of failure in maximal repair at the suture-tendon interface and the inherent inferior quality of cuff tissue in large and massive rotator cuff tears, a solution providing both strength and improved cuff biology remains the main goal in preventing retears and allowing enhanced rehabilitation to restore cuff muscle strength. This has led to graft-based approaches for reconstruction in shoulder repair, including bridging reconstruction. Biocomposite grafts encourage new tissue formation but lack structural support, while human dermal allografts provide structural support but fall short in tendon integration. Thus, a biocomposite scaffold is introduced to combat these limitations. In this technique, we describe placing the BioBrace graft (Biorez), eliminating tension at the graft-suture interface, providing strength and tissue integration.