Comparable Graft Failure Rates and Outcome in Superior Capsular Reconstruction Yet Faster Pain Relief Using Dermal Allograft and Faster Motion Recovery Using Tensor Fascia Lata Autograft.

Abstract

To directly compare clinical outcomes of superior capsular reconstruction (SCR) using dermal allografts (DAs) and tensor fascia latae (TFL) autografts and determine independent factors associated with patient satisfaction and graft failure. This retrospective study was conducted between June 2013 and November 2021. Patients who underwent SCR using DA or TFL were included. Inclusion criteria included irreparable rotator cuff tears, a minimum 12-month follow-up, and age older than 50 years. Clinical outcomes were evaluated preoperatively and at 6 months, 1 year, and final follow-up. Logistic regression analysis was performed to identify independent factors associated with graft failure and patient satisfaction. Trend analysis was conducted to evaluate changes in outcomes over time. Of initially eligible patients, 16.7% (8/48) from the DA group and 17.1% (7/41) from the TFL group were excluded due to loss to follow-up, resulting in a total of 74 patients analyzed. The average follow-up duration was 34.6 months (range, 23.8-66.0 months) in the DA group and 33.8 months (range, 12.0-60.0 months) in the TFL group. The overall graft failure rate was 35.0% in the DA group and 32.4% in the TFL group (P = .810). Logistic regression revealed older age, use of DA, and reduced postoperative acromiohumeral distance as significant predictors of graft failure. Graft failure, specifically at the greater tuberosity site, was strongly associated with lower patient satisfaction (odds ratio, 0.007; 95% confidence interval, 0.000-0.124; P = .001). The TFL group showed faster recovery of range of motion, while the DA experienced more rapid pain relief. This study showed that graft failure at the greater tuberosity significantly influenced patient dissatisfaction following SCR. Both graft types (DA and TFL) showed similar graft failure rates and clinical outcomes. However, the DA group experienced faster pain relief, whereas the TFL group had earlier recovery of shoulder range of motion. Level III, retrospective comparative case series.