Purpose
To evaluate the impact of graft thickness on clinical outcomes and graft retear after
superior capsular reconstruction (SCR) using a hybrid graft combining both fascia
lata autograft and dermal allograft in patients with massive rotator cuff tear (MRCT).
Methods
Between January 2017 and February 2019, this study enrolled 58 patients with MRCT
who underwent SCR using a hybrid graft combining both fascia lata autograft and dermal
allograft. We evaluated clinical outcomes and compared differences between the graft
intact and the graft retear group. Moreover, subgroup analysis was performed for patients
having a preoperative acromiohumeral distance (AHD) less than or equal to the used
graft thickness (group 1) and the results were compared with those for preoperative
AHD greater than the used graft thickness (group 2).
Results
Fifty-five patients who underwent MRCT with a mean age of 65.1 ± 5.7 years old were
followed up during a mean period of 30.5 ± 6.5 (range, 24-37) months. There were significant
differences in clinical outcome measures preoperatively and postoperatively (P < .05). There were no significant differences in clinical outcomes between the graft
intact and graft retear groups (P > .05). The subgroup analysis revealed that the retear (68.6% vs 30.4%, P = .004) and subacromial erosion rates (91.4% vs 60.9%, P = .005) were significantly greater in for patients having a preoperative AHD less
than or equal to the used graft thickness (group 1).
Conclusions
SCR using a hybrid graft combining both fascia lata autograft and dermal allograft
is promising with improved clinical scores (P < .05) irrespective of the graft integrity. The use of a graft with a thickness greater
than a patient’s preoperative AHD could increase graft retear and subacromial erosion
rates after SCR. However, there was no significant difference in clinical outcomes
according to the relationship between used graft thickness and preoperative AHD.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: December 20, 2021
Accepted:
November 30,
2021
Received:
June 2,
2021
See commentary on page 1793Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Chang Hee Baek, M.D., and Jung Gon Kim, M.D., contributed equally to this work.
This research was performed at Yeosu Baek Hospital.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
