Donor site morbidity and patient satisfaction after arthroscopic superior capsule reconstruction using fascia lata autograft for irreparable rotator cuff tears

Donor site morbidity-previously a major concern-remains a considerable issue in arthroscopic superior capsule reconstruction using a fascia lata autograft due to the limited scientific evidence. We aimed to evaluate donor site morbidity and patient satisfaction after arthroscopic superior capsule reconstruction using a fascia lata autograft for irreparable rotator cuff tears. We hypothesized that the procedure would result in certain donor site morbidities, would not have a significant impact on daily activities, and that improvements in shoulder function could compensate for donor site morbidity after superior capsule reconstruction. This prospective study enrolled consecutive patients with irreparable rotator cuff tears who underwent arthroscopic superior capsule reconstruction between 2020 and 2023 and completed 2 years of follow-up. After harvesting the fascia lata autograft, the femoral attachment of the gluteal maximus was repaired. Donor site morbidity and patient satisfaction were assessed at 2-year follow-up using the Questionnaire on Subjective Satisfaction and Donor-Site Morbidity and a standardized subjective questionnaire. Functional outcomes of the thighs and hips were assessed using the visual analog scale (VAS) for thigh pain and the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). Shoulder function was assessed using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, VAS score for shoulder pain, and active shoulder range of motion. Thirty-nine patients were included (18 women, 21 men; mean age, 67.6 years [range, 48-84]). The ASES score significantly improved postoperatively (from 48.4 to 90.3 points, P < .0001). Active shoulder elevation significantly increased postoperatively (from 87.9&#xb0; to 149.4&#xb0;, P < .0001). The mean VAS score in the thigh was 0.6. No significant difference was observed in the JHEQ scores between the donor and healthy sides. No patients reported donor site morbidity-related restrictions in daily activities. Overall, 94.9% of the patients were satisfied with the clinical outcomes and reported that improvements in shoulder function compensated for thigh symptoms. The postoperative ASES score and cosmetic satisfaction showed positive correlations with overall satisfaction after superior capsule reconstruction (r = 0.51, P = .0008, and r = 0.63, P < .0001, respectively). Arthroscopic superior capsule reconstruction using a fascia lata autograft harvested with the open technique achieved favorable clinical outcomes and high patient satisfaction. Herein, approximately half of the patients experienced donor site morbidities, including thigh deformity, muscle weakness, and thigh pain, without limitations in daily activities owing to thigh symptoms. Most patients accepted the donor site morbidities given the improvement in shoulder symptoms.