Editorial Commentary: Can Patch Augmentation Resurrect Superior Capsule Reconstruction?

Graft tear is the primary mode of failure after superior capsule reconstruction, and graft tear correlates with clinical outcome. Thicker fascia lata autografts (6-8 mm) are associated with lower tear rates, but the fascia lata is not always thick enough to allow such a harvest. Incorporating a reinforced polyester patch between 2 thin fascia lata layers can more than double time-zero ultimate load and raise stiffness to levels comparable to a thick graft. However, the biologic implications of a thin patch-augmented graft require further study.