Anterior Capsule Reconstruction

In patients with irreparable tears of the subscapularis tendon, reconstruction with an allo- or autograft may be a viable therapeutic option. However, the postoperative results of published techniques show varying rates of success. Using a human acellular dermal allograft for an anterior capsule reconstruction (ACR) may offer additional benefits such as superior mechanical strength compared to smaller and thinner tendon allografts used in the past. The implantation of an allograft replaces the torn subscapularis tendon’s role as the anterior joint stabilizer, thus preventing the humeral head from migrating anteriorly by acting as a static restraint. This surgery alters shoulder biomechanics as the graft acts as a static restraint, thereby centering the humeral head during active movement, preventing anterior escape, and thus leading to improved function and pain relief.