Surgical management of massive irreparable cuff tears: Superior capsular reconstruction.

Surgical management of massive irreparable cuff tears: Superior capsular reconstruction.

Noyes MP; Haidamous G; Spittle NE; Hartzler RU; Denard PJ

Current reviews in Musculoskeletal Medicine

2020

2020-08-22

PURPOSE OF REVIEW: Superior capsular reconstruction (SCR) is a surgical procedure that has been developed to provide an alternative for joint preservation in patients with massive irreparable rotator cuff tears. The purpose of this review is to assess the improvements in biomechanical properties and functional outcomes of this novel procedure. RECENT FINDINGS: Biomechanically, SCR decreases superior translation and subacromial contact pressure. Glenoid fixation is maximized with three anchors, while margin convergence to any remaining rotator cuff improves stability, and findings vary based on graft type. Clinically, SCR has been associated with improvement in functional outcome in the setting of an isolated procedure, or in conjunction with rotator cuff repair. Outcomes appear to be dependent upon indications. However, in select cases, SCR may even be successful in reversing pseudoparalysis. SCR seems to lead to improved biomechanics for the cuff-deficient shoulder resulting in satisfactory functional outcomes. While surgical techniques have evolved, further research is needed to optimize graft healing and longer follow-up studies are needed to continue to refine indications for SCR as a joint preservation effort in the setting of irreparable massive rotator cuff tears without arthritis.

Reconstruction; Arthroscopic; Irreparable; Rotator cuff: massive; Superior capsule

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journalArticle

1935-973X 1935-9748

NEOMED College of Medicine

Department of Orthopaedics

August 2020 List

Aultman Hospital