Related Experiment Video
Updated: Mar 18, 2026
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
Improved Patient-Reported Outcomes Following Human Dermal Allograft Patch Augmentation With Footprint Medialization
Seong Hun Kim1, Sang-Jin Shin2
1Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Gyeonggi, Republic of Korea.
Purpose:
To evaluate the clinical and radiologic outcomes of arthroscopic partial repair combined with human dermal allograft (HDA) patch augmentation in patients with retracted rotator cuff tears larger than 2.5 cm, where complete footprint coverage was not feasible.
Methods:
We prospectively enrolled patients with retracted full-thickness rotator cuff tears measuring larger than 2.5 cm. Indication for human dermal allograft patch augmentation was residual footprint exposure exceeding 1.5 × 1.5 cm after arthroscopic rotator cuff repair with footprint medialization less than 1 cm. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score, Constant score, Single Assessment Numeric Evaluation, Visual Analog Scale for pain, and active range of motion. The minimal clinically important difference was calculated using the American Shoulder and Elbow Surgeons score. Retear was evaluated via magnetic resonance imaging at 6 months and annual ultrasound examination.
Results:
Forty patients (mean age 64.5 ± 8.8 years) were included. The minimum follow-up was 17 months, with a mean of 19.7 ± 2.5 months (range, 17-28 months). At final follow-up, clinical outcomes improved significantly: Visual Analog Scale from 4.9 ± 1.8 to 0.4 ± 0.5, Single Assessment Numeric Evaluation from 31.7 ± 18.2 to 94.1 ± 8.3, American Shoulder and Elbow Surgeons from 68.4 ± 16.8 to 93.7 ± 5.3, and Constant from 61.1 ± 15.1 to 89.2 ± 5.7 (P < .001). Active range of motion also increased significantly (P < .001). All patients exceeded the minimal clinically important difference. Retear occurred in 3 patients (7.5%) on 6-month magnetic resonance imaging. No additional retears were found on annual ultrasound examination.
Conclusions:
Arthroscopic partial repair with footprint medialization and human dermal allograft patch augmentation yielded significant improvements in patient-reported outcomes and a low retear rate for retracted rotator cuff tears, especially when the tear size more than 2.5 cm and residual footprint exposed area is exceeding 1.5 × 1.5 cm after medialization to less than 1 cm.
Level Of Evidence:
Level IV, retrospective case series.
