{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:54:21Z","timestamp":1781520861078,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to assess clinical and radiological outcomes of arthroscopic superior capsular reconstruction (SCR) using human\u2010derived acellular collagen matrix (hACM) in patients with posterosuperior massive irreparable rotator cuff tears (MIRCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed patients who underwent arthroscopic SCR using hACM between April 2018 and December 2021. Inclusion criteria were intact or repairable subscapularis tendon, failure of nonoperative treatment, age under 80 years, Goutallier grade \u22642 for the infraspinatus and minimum clinical follow\u2010up of 2 years. Patients lost to follow\u2010up or who underwent revision SCR were excluded. Primary outcome was Constant\u2013Murley score (CMS). Radiographic evaluation included acromio\u2010humeral interval (AHI) measurements and assessment of graft integrity 2 years after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010eight patients met inclusion criteria at mean of 26 months postoperatively, including 20 (41.7%) women and 28 (58.3%) men, with a mean\u2009\u00b1\u2009standard deviation (SD) age of 63.5\u2009\u00b1\u20097.1. CMS increased from preoperative median values of 39.5\u201373.0 at 1 year (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and 76.04 at 2 years (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Two patients (4.2%) did not achieve the minimal clinically important difference at 2 years. Improvement was consistent across all subdomains: pain, activities of daily living, range of motion, and strength. Mean\u2009\u00b1\u2009SD AHI before surgery was 0.58\u2009\u00b1\u20090.21\u2009cm, changing to 0.51\u2009\u00b1\u20090.21\u2009cm after SCR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). Graft integrity at 2 years was observed in 20 (41.7%) cases. No significant differences in pre\u2010 versus post\u2010variation in clinical outcomes were observed between patients with or without graft integration, but the variation in AHI differed significantly between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030): AHI remained stable in patients with graft integration, whereas it decreased significantly in those without integration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SCR using hACM achieved significant clinical improvement and may represent a viable non\u2010prosthetic approach for posterosuperior MIRCTs in middle\u2010aged patients, though further studies are needed to confirm effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV case series with no comparison group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70364","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:05:11Z","timestamp":1772989511000},"page":"2215-2223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Superior capsular reconstruction using human acellular collagen matrix: A 2\u2010year follow\u2010up study in posterosuperior massive irreparable rotator cuff tears"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9958-3346","authenticated-orcid":false,"given":"Pablo","family":"Terol\u2010Alcayde","sequence":"first","affiliation":[{"name":"Orthopedic Surgery and Traumatology Department Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"},{"name":"Biomedical Research Institute INCLIVA Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"Mart\u00edn\u2010Gorgojo","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Department Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"},{"name":"Biomedical Research Institute INCLIVA Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Ferrando\u2010Meseguer","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Department Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"},{"name":"Biomedical Research Institute INCLIVA Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Silvestre\u2010Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Department Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"},{"name":"Biomedical Research Institute INCLIVA Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"},{"name":"Department of Surgery. 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