Background: We hypothesized that in a cadaveric massive rotator cuff tear (MCT) model, a fascia lata (FL) allograft superior capsular reconstruction (SCR) would restore subacromial contact pressure and humeral head superior translation without limiting range of motion (ROM). Therefore, the objective of this study was to compare these parameters between an intact rotator cuff, MCT, and allograft FL SCR. Methods: Eight fresh cadavers were studied using a custom shoulder testing system. ROM, superior translation, and subacromial contact pressure were measured in each of 3 states: (1) intact rotator cuff, (2) MCT, and (3) MCT with SCR. Results: Total ROM was increased in the MCT state at 60 of abduction (P ¼ .037). FL SCR did not restrict internal or external rotational ROM. Increased superior translation was observed in the MCT state at 0 and 30 of humeral abduction, with no significant difference between the intact cuff and FL SCR states. The MCT state significantly increased mean subacromial contact pressure at 0 of abduction with 30 and 60 of external rotation, and FL SCR restored this to intact levels. Peak subacromial contact pressure was increased for the MCT state at 0 of abduction with 30 and 60 of external rotation, as well as 30 of abduction with 30 of external rotation. Conclusion: This study demonstrates a tensor FL allograft preparation technique for use in SCR. After MCT, FL SCR restores ROM, superior translation, and subacromial contact pressure to the intact state.

Patellar instability is a debilitating condition, and trauma due to the dislocations may severely damage the articular cartilage of the patellofemoral joint. The lack of healing capacity of cartilage makes treatment of such lesions challenging. In young patients, preservation of native bone and cartilage is a priority, and therefore arthroplasty procedures should be avoided even in relatively larger lesions. Fresh osteochondral allografting has been described for these difficult and complex cases, with recent studies showing promising results. In this surgical technique, we describe the use of bipolar osteochondral allografts of the patella and trochlea and patellofemoral joint reconstruction for large bipolar full-thickness cartilage defects due to recurrent dislocation events.