Abstract
The purpose of this study was to evaluate biomechanical and histopathological results
of a retrieved acellular human dermal allograft (AHDA) after superior capsule reconstruction
(SCR). A 67-year-old man with pseudoparalysis was treated with SCR for an irreparable
posterosuperior rotator cuff tear. The patient failed clinically 4.5 months postoperatively
and elected to undergo reverse total shoulder arthroplasty (RTSA). At the time of
RTSA, the AHDA was harvested. Biomechanical and histopathologic analyses were performed
and compared to native grafts. Failure loads for the explanted graft and native grafts
1 and 2 were 158, 790, and 749 N, respectively. The stiffness values were 20.2, 73,
and 100.5 N/mm. The displacement at failure for each graft was 10.1, 27.9, and 17.0 mm.
Hematoxylin and eosin and Masson's trichrome staining revealed the presence of cells
in all portions of the AHDA. The medial portion presented extensive cellular infiltration,
the middle portion moderate, and the lateral portion the least infiltration. Although
the only identifiable cells in the lateral portions were found in pockets on the interior
of the graft, cells were mainly localized on the exterior. Postoperative cell incorporation
could be found in acellular dermal allograft after SCR. However, biomechanical properties
in the early postoperative phase were inferior compared with unimplanted allografts.
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Article info
Publication history
Accepted:
July 3,
2019
Received:
April 28,
2019
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.A. reports grants from Arthrex; other from ON Foundation. L.L. and A.C.S. are Steadman Philippon Research Institute employees. P.J.M. reports consultant fees and royalties from Arthrex, Medbridge, Springer Publishing; stocks from GameReady, VuMedi; research activities supported by the Steadman Philippon Research Institute and Vail Valley Medical Center. This research was supported by the Steadman Philippon Research Institute, which is a 501(c)(3) nonprofit institution supported financially by private donations and corporate support form the following entities: Smith & Nephew Endoscopy, Arthrex, Siements Medical USA, Ossur Americas, and Vail Valley Medical Center. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2019 by the Arthroscopy Association of North America
