Rotator cuff tears can cause pain and dysfunction. Surgery is often warranted to help improve function and long term joint preservation. However, rotator cuff repairs continue to have a high retear rates despite current anchors and techniques. The cow patch, also known as a bovine collagen or bioinductive patch, has been shown to help improve healing rates for rotator cuff tendons.
A 2025 randomized controlled trial found that bovine bioinductive collagen implants reduced retear rates from 35.1% to 12.3% at 2-year follow-up in medium-to-large posterosuperior tears. While structural healing improves, patient-reported outcomes show inconsistent benefits. The 2025 RCT found no differences between groups in ASES scores, Constant-Murley scores, or pain levels despite better healing rates, though patients with intact tendons had better outcomes than those with failed repairs. Two studies found bovine collagen implants cost-effective due to increased tendon healing.
Bovine collagen patches have also been shown to help heal partial rotator cuff tendon tears. A recent study demonstrated that using a bovine collagen patch can help improve patient reported outcomes similar to the traditional take down and repair method at 1 year follow up. However, some studies have reported increased stiffness with the patch in the setting of partial rotator cuff pathology.
The August 2025 updated AAOS Clinical Practice Guidelines for Management of Rotator Cuff Injuries provide a strong recommendation for using bioinductive implants to augment rotator cuff repairs. If you are planning to undergo rotator cuff repair surgery, discuss with your surgeon about augmentation with a bovine collagen patch to improve healing.
Figure 1 shows an arthroscopic picture of a rotator cuff tendon tear while Figures 2 and 3 demonstrate a rotator cuff tendon repair augmented with a bioinductive bovine collagen patch.
Amit Momaya, MD is a board certified orthopedic surgeon who specializes in sports medicine. He serves as the Chief of Sports Medicine at UAB, resides on the editorial board of research journals, and takes care of several collegiate and professional teams in Alabama. This blog post is for educational purposes only. Please consult with your physician for a discussion on bovine patches and rotator cuff healing.
Figure 1
Figure 2
Figure 3
