Massive irreparable rotator cuff tendon tear is a challenging pathological condition in shouldersurgery. For younger and physically active patients, superior capsule reconstruction (SCR) is gaining popularity.1 The thickness of the graft affects the rate of postoperative graft retear. According to reports, a graft thickness of 6 to 8 mm is necessary. Therefore, our technique uses 2 layers of autologous fascia lata combined with 1 layer of allograft mesh and suture reinforcement as a graft to improve the stability above the shoulder joint and reduce graft failure.2 In addition, there are mechanical and biological advantages of increasing the graft thickness and healing potential through the hybrid graft, combined with the allogeneic dermis.3,4 This method not only restores the pressure of the joint capsule on the humeral head but also connects the residual end of the supraspinatus (SSP) muscle to the graft, which means that the residual end of the rotator cuff is partially integrated onto the surface of the patch. By bridging the SSP and infraspinatus muscles onto the SCR patch, muscle strength is restored. Therefore, we used this method, combining the advantages of SCR and bridging, and reduced the graft retear rate through this thicker patch.5,6
This technology has the advantages of traditional SCR while retaining the dynamic strength of the rotator cuff and preserving the function and biomechanical environment of the SSP and infraspinatus muscles. It is more conducive to restoring shoulder joint function and promoting graft-bone interface healing. The shortcomings of this technique include slightly more complex suture management, longer surgical time, and the possibility of increased postoperative infections and other sutures. In addition, this technique tests arthroscopic techniques, and shoulder joint specialists may need to master this technique, which may result in a slightly longer learning curve.
https:///10.1016/j.eats.2025.103627
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