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Updated: Oct 9, 2025
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
Classification system of graft tears following superior capsule reconstruction
Raffy Mirzayan1, Daniel C Acevedo2, Margo A Sidell3
1Kaiser Permanente Southern California, Department of Orthopaedics, Baldwin Park, CA, United States of America.
Objective:
Superior capsule reconstruction (SCR) is a treatment option for irreparable massive rotator cuff tears (MRCT). The purpose of this study is to describe a classification system for graft integrity and tear location.
Methods:
Patients who underwent SCR at a single institution were included. Pre-operative age, gender, prior surgery, Hamada grade, and Goutallier stage were recorded. An MRI was performed postoperatively to assess graft integrity and tear location.
Results:
53 patients met inclusion criteria. Mean age was 60.1 ± 7.9 years. A post-operative MRI was performed in 42 (80%) patients at a mean of 14 ± 7 months (range, 6-40 months). MRIs demonstrated an intact graft in 16 (38%) shoulders. Of the 26 graft tears, 14 (54%) were from the glenoid, 5 (19%) mid-substance, 6 (23%) from the tuberosity, and 1 (3.8%) had complete graft absence.
Conclusion:
Graft tears are common following SCR. We describe four different graft tear locations and submit a classification system that can be used in future studies to better compare outcomes based on graft integrity and tear location. Clinical correlation with graft integrity and graft tear location needs to be further investigated.
