Irreparable rotator cuff tears are challenging to treat, especially in highly active and young patients. Superior capsule reconstruction is a joint-preserving, anatomic, and arthroscopic option that has shown promising mid-term results. Over time, this procedure has undergone evolution in terms of patient selection and technical aspects, such as graft choices and fixation methods. Initially, superior capsule reconstruction was used for isolated irreparable tears of the supraspinatus tendon; now, the indication has widened to technically irreparable massive posterosuperior rotator cuff tears. The trend in North America and Europe has been toward using human dermal allografts, as opposed to fascia lata autografts, to avoid donor-site morbidity and reduce surgery time. How these modifications affect clinical outcomes and whether dermal allografts heal remains unknown.
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