How to Use a Graft in Irreparable Rotator Cuff Tears: A Literature Review Update of Interposition and Superior Capsule Reconstruction Techniques

• Published in: Current reviews in musculoskeletal medicine Vol. 11; no. 1; pp. 122 - 130
• Main Authors: Wall, Kevin C., Toth, Alison P., Garrigues, Grant E.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2018
• Subjects: Medicine; Medicine & Public Health; Minimally Invasive Surgery; Orthopedics; Rehabilitation Medicine; Rotator Cuff Repair (M Tao and M Teusink; Rotator Cuff Repair (M Tao and M Teusink, section editors); section editors; Sports Medicine; Surgery; Surgical Orthopedics; Topical Collection on Rotator Cuff Repair; Irreparable; Rotator cuff tear; Graft; Superior capsule reconstruction; Interposition; Shoulder
• ISSN: 1935-973X; 1935-9748
• DOI: 10.1007/s12178-018-9466-3

Purpose of Review
To introduce the challenges in addressing irreparable rotator cuff tears and examine the surgical options, specifically interposition grafting and superior capsule reconstruction.
Recent Findings
Interposition grafting of rotator cuff tears shows promising results in reducing pain and improving function postoperatively and one study demonstrated that it performs significantly better than partial repair alone. Superior capsule reconstruction has become popular rapidly, but given the novelty of the procedure, there is currently a paucity of outcomes data to review.
Summary
Irreparable rotator cuff tears are a challenging condition with a variety of surgical options available. Two such options—interposition and superior capsule reconstruction—both employ grafts in an attempt to restore joint stability and function. In the past 3 years, literature discussing interposition grafting has explored the different types of grafts, and mostly employed pre-post analysis. The recent superior capsule reconstruction articles strictly used human dermal allograft and offer a variety of surgical techniques without quantitative data.