Longitudinal efficacy of acellular dermal allograft following superior capsular reconstruction of irreparable rotator cuff tears.

Abstract

Superior capsular reconstruction (SCR) remains an option for irreparable rotator cuff tears, especially for active patients. While fascia lata grafts were first used with SCRs, acellular dermal allografts have demonstrated similar postoperative outcomes and complication rates. Few studies report long-term clinical outcomes following use of acellular dermal allografts. The aim of the current study is to evaluate long-term efficacy of allograft usage in SCR through patient reported clinical outcomes. A retrospective review of patients undergoing SCR with use of dermal allografts from 2015 to 2021 was performed. Exclusion criteria included patients lost to follow up, revision or removal of graft, and inadequate follow up timepoints. Demographics and operative characteristics were collected. To evaluate efficacy of graft, numerical rating scale (NRS), American Shoulder and Elbow Score (ASES) were assessed postoperatively. Shoulder range of motion (ROM) was also evaluated by the 6-month postoperative timepoint. Improvement in NRS, ASES, and shoulder ROM from baseline values were evaluated using a <i>t</i>-test. The final cohort was 21 patients with two patients undergoing revision and removal of the graft. Mean follow up time was 36.9 months. No major postoperative complications were recorded. Mean preoperative NRS and ASES score was 5.7 and 38.4, which both significantly improved postoperatively (p < 0.001). Patients demonstrated improvements in forward flexion, abduction in 90° rotation, and external and internal rotation. Use of acellular dermal grafts in SCR procedures for irreparable rotator cuff tears remains a viable long-term solution to restore shoulder function.