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May 17, 2026Arthroscopy The Journal of Arthroscopic and Related Surgery0 citationsOpen Access

Editorial Commentary : When it Comes to Graft Thickness for Superior Capsular Reconstruction, Go Thick or Go Back to the Original

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JEJosef K. Eichinger

Key Points

  • To highlight the significance of graft thickness in superior capsular reconstruction for chronic rotator cuff tears.
  • Review of superior capsular reconstruction techniques in clinical practice.
  • Comparison of graft types including autograft, allograft, and porcine xenograft.
  • Examination of literature discussing biomechanical properties of various graft thicknesses.
  • Thicker grafts (6 to 8 mm) offer better biomechanical support compared to thinner options.
  • Surgeons often avoid autograft fascia lata due to time and morbidity concerns, opting for allografts instead despite their potential deficiencies.

Abstract

Chronic, irreparable rotator cuff tears continue to be a problem but there are multiple options for treatment, including superior capsular reconstruction (SCR). The original SCR technique described by Mihata used autograft fascia lata. However, most surgeons performing SCR do not use autograft fascia lata; instead, they desire to avoid obtaining autograft fascia lata for time concerns and donor site morbidity. However, the use of allografts for SCR, particularly those allograft options with smaller thicknesses, may be deficient. Recent literature shows the biomechanical value of using a thicker porcine xenograft compared with a thinner human dermal allograft. Whatever graft is chosen, the surgeon should ensure the graft thickness replicates the 6 to 8 mm of thickness of graft used by Mihata in his landmark paper describing SCR.

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Cite This Study

Josef K. Eichinger (2026) studied this question.

synapsesocial.com/papers/6a095b8e7880e6d24efe164dhttps://doi.org/10.1002/arj.70364
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Superior capsule reconstruction using a single 6-mm-thick acellular dermal allograft for massive rotator cuff tears: a biomechanical cadaveric comparison to fascia lata allograft2021 · 25 citations
  2. 2Long-term Clinical and Structural Outcomes of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears: 10-Year Follow-up2025 · 26 citations
  3. 3Five-Year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears2019 · 216 citations
  4. 4Biomechanical Role of Capsular Continuity in Superior Capsule Reconstruction for Irreparable Tears of the Supraspinatus Tendon2016 · 289 citations
  5. 5A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear2017 · 208 citations