WHICH DERMAL ALLOGRAFT SHOULD I USE FOR ROTATOR CUFF TEARS? A COMPARATIVE STUDY WITH TWO-YEAR MINIMUM FOLLOW-UP

Rotator cuff tears are notoriously difficult to manage with high rates of failure following repair. Dermal acellular allografts can be used to perform bridging reconstruction with greater success than maximal repair (i.e., the current gold standard); however, research comparing allograft types for the bridging technique in large to massive rotator cuff tears is lacking. Allograft availability is subject to change, therefore, knowing whether different grafts provide different healing outcomes helps to inform on best practice. This study's purpose was to compare healing and patient-reported outcomes following bridging rotator cuff repair in patients who received an AlloPatch dermal allograft to those who received a GraftJacket dermal allograft with a minimum of two-years follow-up. This was a retrospective study of 117 consecutive patients who underwent bridging repair using either an AlloPatch or GraftJacket dermal allograft for large to massive rotator cuff tears from 2012-2021. All patients had a minimum of two-years follow-up. Data collected included demographic information, pre- and post-operative magnetic resonance images (MRIs), Western Ontario Rotator Cuff (WORC) Index, and the Disabilities of the Arm, Shoulder, and Hand (DASH) scores. The primary outcome measure was healing, determined via MRI, with secondary outcome measures of patient-reported outcomes. There were no significant demographic differences between groups. The mean time from surgery was 8.09 ± 1.66 years for the GraftJacket group (n= 75), and 3.29 ± 1.03 years for the AlloPatch group (n= 40). Graft healings were comparable in the two groups at the minimum 2-year follow-up (GraftJacket: 70% healed, 19% partial tears, 11% complete tears, vs AlloPatch: 60% healed, 20% partial tears, 20% complete tears; p= 0.445). Pre-operatively, there was no difference in either the WORC or DASH scores between groups (p= 0.541 and p= 0.253, respectively), and both groups had similar pre- to post-operative improvements in WORC and DASH scores at two-years follow-up (p= 0.381 and p= 0.570, respectively). AlloPatch and GraftJacket dermal allografts result in similar healing and patient-reported outcomes following bridging reconstruction for rotator cuff tears at two-years post-operative. These findings provide evidence that GraftJacket and AlloPatch dermal allografts offer comparable outcomes for treatment of large to massive rotator cuff tears.