Arthroscopy. 2021 Sep;37(9):2797-2799. doi: 10.1016/j.arthro.2021.05.037.
Superior capsular reconstruction (SCR) is increasingly considered a "game-changer" for young patients with irreparable rotator cuff tears. Popular graft choices include fascia lata autograft (FLA) and human dermal allograft (HDA), with the latter strongly preferred in North America and Europe. Despite that, there seems to be a general perception that FLAs are associated with better healing rates due to better biology. However, critical analysis of the literature demonstrates abundant limitations that preclude strong conclusions about whether one graft type is optimal. Furthermore, recent studies have demonstrated that HDAs used for SCR have good healing potential and are also associated with generally good short-term clinical outcomes. A clinical pearl is that humeral sided repair failures are not uncommon, and double-row repair techniques should be thoughtfully considered. The main downside of FLAs is the associated donor site morbidity. Given the lack of proven advantage of FLAs, the impetus to move away from the current trend to use HDAs is low.
肩袖全层撕裂的年轻患者，越来越多的人选择行上盂唇前后部（Superior capsular reconstruction，SCR）重建术，该术式被认为是此类患者的“游戏规则改变者”。目前常用的移植物包括阔筋膜条（fascia lata autograft，FLA）和人真皮移植物（human dermal allograft，HDA），尽管 HDA 在北美的应用更为广泛，但仍有观点认为 FLA 因其更好的生物学活性，愈合率更高。然而，对现有文献的批判性分析显示，其存在大量局限性，无法就哪种移植物类型更优得出明确结论。此外，最近的研究表明，用于 SCR 的 HDA 具有良好的愈合潜力，且短期临床效果通常较好。有临床经验提示，肩袖在肱骨侧的修复失败并不少见，应慎重考虑采用双排固定技术。FLA 的主要缺点是供区并发症较多。鉴于 FLA 并未显示出明显优势，目前应用 HDA 的趋势不太可能改变。
