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. 2022 Feb 4;10(2):23259671211073133.
doi: 10.1177/23259671211073133. eCollection 2022 Feb.

Donor-Site Morbidity After Autologous Fascia Lata Harvest for Arthroscopic Superior Capsular Reconstruction: A Midterm Follow-up Evaluation

Ana Catarina Leiria Pires Gago Ângelo  1   2   3 , Clara Isabel de Campos Azevedo  1   2   3   4   5
Affiliations

Donor-Site Morbidity After Autologous Fascia Lata Harvest for Arthroscopic Superior Capsular Reconstruction: A Midterm Follow-up Evaluation

Ana Catarina Leiria Pires Gago Ângelo et al. Orthop J Sports Med. .

Abstract

Background: Autologous fascia lata (AFL) graft use in arthroscopic superior capsular reconstruction (ASCR) is effective for the treatment of irreparable rotator cuff tears (RCTs). Although donor-site morbidity (DSM) is a recurrent argument against AFL graft use, scientific evidence for this argument is lacking.

Purpose: To report the midterm clinical follow-up evaluation of DSM in ASCR using minimally invasively harvested AFL grafts and compare thigh function and patient satisfaction with those of an unharvested control group.

Study design: Cohort study; Level of evidence, 3.

Methods: Of 66 consecutive patients who underwent ASCR using a minimally invasively harvested AFL graft, 39 patients with a minimum follow-up of 24 months were retrospectively evaluated (ASCR group) and compared with 39 randomly selected patients who underwent arthroscopic RCT repair by the same surgeons (control group). The functional outcomes of both thighs were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patient satisfaction was evaluated using the Patient Scar Assessment Questionnaire (PSAQ) and a subjective questionnaire. Pain was quantified using a visual analog scale (VAS).

Results: The ASCR group had a mean age of 65 years (range, 51-77 years) and a mean follow-up of 47 months (range, 24-66 months). The WOMAC score in the harvested thigh differed by 0.8% from that in the contralateral thigh (P = .002). The mean PSAQ score differed by 6 points from the minimum PSAQ score (P < .001). Overall, 95% of the patients indicated that they would undergo the same surgery again and that the shoulder outcome compensated for the thigh symptoms. There was no significant association between the presence of residual thigh symptoms and the willingness to undergo the same surgery again (P = .354). The mean VAS score in the harvested thigh was 0.6 (range, 0-5). There was no significant difference in the average WOMAC score or VAS score between groups (P = .684 and P = .148, respectively).

Conclusion: Despite the proportion of residual symptoms, the associated functional effects were small and not clinically significant, and the vast majority of patients were accepting of the harvest symptoms given the improvement in shoulder function.

Keywords: donor-site morbidity; fascia lata; minimally invasive; superior capsular reconstruction.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: A.C.L.P.G.A. and C.I.d.C.A. have received consulting fees from ConMed. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
(A) The autologous fascia lata percutaneously harvested from a left thigh through the proximal 2-cm transverse skin incision using the minimally invasive harvesting technique in the beach-chair position. (B, C) The prepared and folded fascia lata graft before and after peripheral suturing, according to the original technique. , (D, E) Pictures of the left thigh of patient 38 at the 3-year follow-up evaluation showing the scars in frontal and side views (arrows).
See this image and copyright information in PMC

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