Related Experiment Video
Updated: Nov 5, 2025
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
Healing and Functional Results of Dermal Allograft Augmentation of Complex and Revision Rotator Cuff Repairs
Surena Namdari1, Thema Nicholson1, Tyler J Brolin2
1Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background:
Primary rotator cuff repairs in complex cases (older patient age, larger tear sizes, chronic tears) and revision repairs are at high risk for failure of healing.
Purpose:
To examine clinical outcomes and healing rates in complex and revision rotator cuff repairs with dermal allograft augmentation.
Study Design:
Case series; Level of evidence, 4.
Methods:
A retrospective study was made of cases performed by 3 fellowship-trained surgeons via a uniform technique involving rotator cuff repairs with allograft augmentation. In all cases, a 1.5-mm, human, decellularized dermal graft was tied on top of the tendon at the medial row and compressed to the rotator cuff footprint using a double-row technique. Postoperative magnetic resonance imaging (MRI) was performed at a minimum of 6 months and American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and 12-Item Short Form Health Survey scores were collected at a minimum of 2 years postoperatively.
Results:
A total of 35 patients (23 revision repairs, 12 primary complex repairs) were included. The mean patient age was 57.9 years (range, 41.0-70.5 years). All shoulders had 2-tendon tears (supraspinatus and infraspinatus), and 8 included the upper 50% of the subscapularis. At a minimum of 2 years after surgery (mean, 3.2 years), mean ASES and SANE scores improved from 42.4 and 35.3 to 77.6 and 73.5, respectively (P < .001). In the 23 patients (66%) with postoperative MRI evaluation, 11 (48%) had images showing the tendons were retorn. ASES (89.7 vs 66.4; P = .04) and SANE (84.1 vs 50.5; P = .02) scores were higher in healed patients than those with retears. The retear group had a higher degree of preoperative fatty atrophy of the infraspinatus (P = .024).
Conclusion:
Double-row arthroscopic repair with dermal allograft augmentation of complex and revision rotator cuff tears led to improved functional outcomes. Approximately half of patients experienced a failure of healing, which was associated with poorer functional results.
