Purpose To compare clinical and magnetic resonance imaging results of patients who underwent superior capsule reconstruction with a 3 mm (Group 1) versus 6 mm (Group 2) human dermal allograft. Methods Between September 2014 and February 2022, patients who underwent superior capsule reconstruction at a single institution, with a minimum of 1‐year follow‐up, were included. Preoperative age, sex, and Hamada grade were recorded. Pre‐ and postoperative acromiohumeral distance, American Shoulder and Elbow Surgeons (ASES), Oxford, visual analog scale (VAS) for pain, and postoperative single‐assessment numeric evaluation score were recorded. Postoperative magnetic resonance image was routinely obtained regardless of symptoms. Results There were 39 shoulders in Group 1 and 22 shoulders in Group 2. There was no difference between in preoperative age ( P = .6412), acromiohumeral distance ( P = .7638), ASES ( P = .4612), and Oxford ( P = .55517). There was significant improvement in both groups in ASES, Oxford, and VAS ( P < .0001), but no difference in acromiohumeral distance for Group 1 ( P = .666) or Group 2 ( P = .1188). There was a significant difference between Group 1 and 2 in postoperative ASES (76.6 vs 94, P = .0002), Oxford (41.7 vs 47, P = .0005), VAS (2.2 vs 0.3, P = .0062), and single‐assessment numeric evaluation (75 vs 92.3, P = .0002). Group 2 had a lower graft tear rate (27.3% vs 64.1%, P = .0057). Group 2 also had a significantly lower lateral‐sided graft failure (0% vs 40%, P = .0099). In Group 1, 87% met minimal clinically important difference for ASES, 77% for Oxford, and 90% for VAS. In addition, 67% met substantial clinical benefit for ASES, 64% for Oxford, and 72% for VAS. In Group 2, 100% met minimal clinically important difference for ASES, Oxford, and VAS and 100% met SCB. Conclusions Patients who undergo superior capsule reconstruction with a 6 mm human dermal allograft have significantly lower lateral‐sided graft tears, leading to better functional outcomes compared with those with 3 mm grafts. Level of Evidence Level III, retrospective comparative study.
Mirzayan et al. (Sun,) studied this question.