Autograft – A soft tissue graft taken locally or from a second surgery site. An example would be the use of autograft fascia lata for superior capsule reconstruction.
Acellular Dermal Matrix (ADM) Allograft – A thick skin graft recovered from a deceased donor (with family authorization). Decellularization, cleansing, and disinfection methods can vary widely been tissue processors.
- Non-sterile dermal allograft – Some tissue processors only cleanse allografts via aseptic processing, which leaves the graft negative for bacterial cultures, but does not ensure sterility. Note: while some processors do not use terminal sterilization, they may still employ gamma irradiation during their aseptic processing.1
- Allograft acellular dermal matrix with medical device-level sterility – These decellularized ADMs are provided at a sterility assurance level (SAL) of 10-6 , meaning that the probability of finding a single viable microorganism is one in one million.2
- Sterilization with e-beam irradiation – This type of sterilization uses beta particles to disrupt nucleic acids. The irradiation type has less penetration depth compared to gamma irradiation.4
- Sterilization with gamma irradiation – The most common method of terminal sterilization. The type of irradiation uses high energy photons to disrupt nucleic acids and penetrates deep into the tissue.5
Synthetic options for rotator cuff repair– These materials can be made from a variety of polymers.7
Xenograft options for rotator cuff repair– These grafts may be derived from cows, pigs, or horses.7 Processing varies widely between manufacturers.