Fascia Lata Autograft Harvest Technique for Superior Capsule Reconstruction With Fascia Lata Using the Mihata Technique

Fascia lata autograft for superior capsule reconstruction (SCR) as described by Mihata is a highly successful and durable procedure in Japan for massive and irreparable rotator cuff tears. In the United States, the procedure was adopted but modified to use an acellular dermal allograft. The results of SCR with dermal allograft have not replicated the success of the original Mihata procedure. The characteristics of the fascia lata autograft are biomechanically and biologically superior to the acellular dermal graft in thickness and stiffness. We present our technique for graft harvest and harvest-site closure, which has demonstrated minimal graft-site issues and been well accepted by patients. The technique for harvesting the fascia lata autograft is the key first step in adhering to the original Mihata SCR technique and replicating their success.