Editorial Commentary: If You're Performing Superior Capsule Reconstruction With Human Dermal Allograft, Prepare a Thick Graft.

Abstract

Pioneered by Mihata and then popularized in the United States by Burkhart and colleagues, superior capsule reconstruction quickly became an essential treatment for massive irreparable rotator cuff tears. More recently, enthusiasm seems to have faded as the surgery is highly resource-intensive, technically demanding, and clinical outcomes have been inconsistent, with some studies finding significant structural failure rates. The history of orthopaedic surgery is rife with examples of implants, concepts, and procedures abandoned because of suboptimal results and/or unacceptable complication rates that subsequently have been successfully reimagined, updated, or otherwise improved with subsequent broader adoption and clinical success. The results of recent literature suggest there may still be a role for superior capsule reconstruction with human dermal allograft and that surgeons performing this procedure should consider using a double-thickness folded graft.