Editorial Commentary: Superior Capsule Reconstruction With Dermal Allograft: Effective Marketing or the Real Deal?

The young patient with a massive, irreparable rotator cuff tear is a challenging problem. Not only is this patient population demanding, but of the few surgical options that exist to manage this problem, each have their own unique limitations; as such, the orthopaedic community continues to search for a treatment that maximizes outcome and durability, while minimizing risk and preserving the native shoulder. Over the past few years, there has been considerable interest in a new surgical technique: the superior capsule reconstruction (SCR). Japanese surgeon, Dr. Teruhisa Mihata, originally described this technique using fascia lata autograft; however, dermal allograft has become the primary graft option in North America, and despite a lack of evidence to support its clinical use, the annual volume of SCR with dermal allograft has risen exponentially. Although this increasing popularity speaks to limitations of the current treatment options for this complex clinical problem, it also calls into question the potential for commercial bias and begs the question: is SCR with dermal allograft truly an effective treatment for the young patient with a massive, irreparable rotator cuff tear?