Superior Capsular Reconstruction using acellular dermal allograft combined with remaining rotator cuff augmentation improved shoulder pain and function at one year after the surgery.

Abstract Purpose The purpose of this study is to report structural integrity and clinical outcomes of superior capsular reconstruction (SCR) using a 4–5 mm acellular dermal allograft combined with augmentation of the remaining rotator cuff to the graft. Methods We prospectively recruited 21 patients with symptomatic irreparable rotator cuff tear who required SCR. At least 6 months after the SCR, we evaluated each patient’s graft healing by magnetic resonance imaging (MRI). We also assessed the range-of-motion (ROM), strength for forward flexion and external rotation, visual analog scale for pain (PVAS), American Shoulder and Elbow Surgeon (ASES) score, and Constant score. At minimum of 1-year after the surgery, we evaluated the number of patients with minimal clinically important differences (MCIDs) for each score to compare patients with healed and unhealed grafts. Results Postoperative MRI showed the grafts intact in 14 patients (66.7%). Among seven patients with unhealed grafts, tears were observed in three patients (42.9%) on the glenoid side, three (42.9%) on the humeral side, and one (14.3%) on both sides. PVAS, ASES score, and the Constant score improved postoperatively (4.0 to 0.7 for PVAS (P Conclusion The graft complete healing rate was 66.7% although pain relief and functional improvement were satisfactory regardless of graft structural integrity. However, muscle strength recovery was not optimal until one year postoperatively.