Editorial Commentary: When it Comes to Graft Thickness for Superior Capsular Reconstruction, Go Thick or Go Back to the Original.

Abstract

Chronic, irreparable rotator cuff tears continue to be a problem but there are multiple options for treatment, including superior capsular reconstruction (SCR). The original SCR technique described by Mihata used autograft fascia lata. However, most surgeons performing SCR do not use autograft fascia lata; instead, they desire to avoid obtaining autograft fascia lata for time concerns and donor site morbidity. However, the use of allografts for SCR, particularly those allograft options with smaller thicknesses, may be deficient. Recent literature shows the biomechanical value of using a thicker porcine xenograft compared with a thinner human dermal allograft. Whatever graft is chosen, the surgeon should ensure the graft thickness replicates the 6 to 8 mm of thickness of graft used by Mihata in his landmark paper describing SCR.