Outcomes in Rotator Cuff Repair Using Graft Reinforcement

Inclusion Criteria: The patient: 1. is an adult male or female between the ages of 40-70 years old; 2. has repairable primary large retracted two-tendon rotator cuff tears measuring from 3 cm to 5 cm; 3. requires surgical repair of single rotator cuff (i.e. one limb); 4. has movement of the non-operative arm defined as shoulder elevation of equal to or greater than 90 degrees and is able to perform postoperative exercises; 5. is able to return for all scheduled and required study visits; 6. is able to provide written informed consent for study participation. Exclusion Criteria: The patient: 1. has irreparable large rotator cuff tears that are found intra-operatively. Note: irreparable is defined by the inability to approximate the tendon to the tuberosity without tension; 2. has a rotator cuff tear \< 3cm (measured intra-operatively); 3. has a rotator cuff tear \> 5cm (measured intra-operatively); 4. has a rotator cuff tear where the subscapularis tendon is disrupted/requires repair; 5. has grade 3 or 4 fatty infiltration of the rotator cuff; 6. has had prior surgical repair to the affected shoulder; 7. is American Society of Anesthesiologists (ASA) Class 4 or 5 (See Appendix I); 8. is a tobacco user; unless tobacco free 6 months prior to surgery and willing to remain tobacco free for the duration of the study. 9. has lower limb injuries requiring walking assist devices such as crutches and walkers; 10. has a known collagen disorder, including systemic lupus erythematous (SLE), rheumatoid arthritis (RA), polymyositis, scleroderma, ankylosing spondylitis, dermatomyositis, osteogenesis imperfecta or the inherited disorders of Sjogren, Larsen, Raynaud, Ehlers-Danlos or Marfan syndrome. 11. has obstacles that pose an inordinately high surgical risk, in the judgment of the certified surgeon; 12. has co-morbid factors which predispose to postoperative infection, such as insulin dependent diabetes, chronic steroid use, malnourishment, cancer, or co-existent infection; 13. has a history of alcohol abuse, illicit drug use, significant mental illness, physical dependence to any opioid, or drug abuse or addiction; 14. is enrolled or plans to enroll in another clinical trial during this study that would affect the patient's safety or results of this trial; 15. has any of the conditions identified within the labeled contraindications, i.e. sensitivity to porcine derived products or polysorbate. 16. has an inability to have a closed MRI conducted. 17. needs a re-operation for a re-tear of the rotator cuff.