Inclusion Criteria:  Patient aged at least 50 years to 75 years. Degenerative cuff tear. Large Full thickness rotator cuff tear (≥ 3cm and < 5 cm ) that is fully repairable. Tears diagnosed using MRI scan. Ability to consent. Agreement to use of human dermal matrix allograft as augmentative patch  Exclusion Criteria:  Previous surgery on the affected shoulder. Osteoarthritic changes. Unable to have MRI Scans. Significant neck pathology. Cognitive problems or language issue. Systemic arthritis Significant dual pathology in the involved shoulder Acute Traumatic tears (< 6 months since injury).