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Study criteria included the presence of a massive irreparable rotator cuff tear with retraction to the glenoid without diffuse bipolar cartilage loss, Grade 4 or 5 Hamada classification, and subscapularis pathology that could not be addressed. All SCR procedures were performed with neutral abduction of the arm at the time of implantation. Outcome measures included visual analog pain scale (VAS) score, the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and active forward elevation (FE) through 2 years postoperatively. Imaging analyses included radiographs, ultrasound, and magnetic resonance imaging at 6 months and 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen patients met\u00a0all study criteria including required follow\u2010up. There were statistically significant improvements in VAS pain (3.3\u20100.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001), ASES (55.0\u201086.5,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), SANE (33.1\u201071.5,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), and active FE (128\u2010172,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0005) with mean follow\u2010up of 2.1 years. Twelve patients (86%) met the minimum clinically important difference in VAS pain, ASES, and SANE. Thirteen grafts (93%) had ultrasonographic evidence for vascularity by 1 year postoperatively. There were 2 graft complications (14%) with one (7%) requiring revision to reverse total shoulder arthroplasty.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Arthroscopic SCR using dermal allograft can be a safe and effective treatment option for patients with massive irreparable rotator cuff tears with statistically significant improvements in VAS pain, ASES, SANE, and active FE at 2\u2010years postoperatively, with 93% of grafts demonstrating vascularity at 1\u2010year postoperatively. Neutral abduction of the arm at the time of implantation resulted in positive clinical outcomes and may decrease graft failure rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2020.10.014","type":"journal-article","created":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T11:08:20Z","timestamp":1602932900000},"page":"489","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":54,"title":["Superior Capsular Reconstruction Using Dermal Allograft Is a Safe and Effective Treatment for Massive Irreparable Rotator Cuff Tears: 2\u2010Year Clinical Outcomes"],"prefix":"10.1002","volume":"37","author":[{"given":"Troy D.","family":"Pashuck","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan M.","family":"Hirahara","sequence":"additional","affiliation":[{"name":"Private Practice Sacramento California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A."},{"name":"Laboratory for Regenerative Orthopaedics University of Missouri Columbia Missouri U.S.A."},{"name":"Mizzou BioJoint Center University of Missouri Columbia Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristi R.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A."},{"name":"Laboratory for Regenerative Orthopaedics University of Missouri Columbia Missouri U.S.A."},{"name":"Mizzou BioJoint Center University of 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