Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis (AANA19)-Massive Rotator Cuff Tears_ An Arthroscopic Treatment Option Using Acellular Human Dermal Matrix-Dr. Mark H. Getelman, M.D.

Massive Rotator Cuff Tears_ An Arthroscopic Treatment Option Using Acellular Human Dermal Matrix-Dr. Mark H. Getelman, M.D.

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Video Transcription

Video Summary

The speaker discusses the off-label use of acellular human dermal matrix allograft for rotator cuff repair beyond one-centimeter defects, emphasizing patient consent for such use. Using a challenging case—a 53-year-old woman with a failed rotator cuff repair and limited options—the speaker demonstrates how dermal allografts can bridge large rotator cuff defects, providing structural support and improving healing by attaching to both tendon and bone. The graft acts dynamically, maintaining muscle function, and shows promising long-term clinical outcomes and improved shoulder function. Compared to superior capsular reconstruction (SCR), which uses autograft and aims to restore superior translation, bridging with dermal allograft focuses on dynamic augmentation when native tissue is sufficient. The speaker highlights surgical techniques, graft positioning, and biological healing challenges, noting that failures often occur medially due to tendon healing limitations. Although SCR is growing rapidly due to reimbursement codes, dermal allografts remain a valuable, tissue-preserving option for rotator cuff management in select patients.

Asset Caption

Instructional Course Lecture: Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis

Keywords

acellular human dermal matrix

rotator cuff repair

dermal allograft bridging

superior capsular reconstruction

tendon healing challenges