Superior capsule reconstruction

The treatment of irreparable massive rotator cuff tears remains a challenge, particularly in young, active patients without glenohumeral arthritis. Superior capsule reconstruction (SCR) is an arthroscopic surgical procedure to reverse superior humeral head migration and restore the muscle balance of the force couples in a cuff-deficient shoulder, without requiring repair of the torn supraspinatus and infraspinatus tendons. SCR can either be performed with a fascia lata autograft, acellular dermal allograft or xenograft, or the long head of the biceps tendon. In order to reconstruct the superior capsule of the glenohumeral joint, the graft is attached medially to the superior glenoid and laterally to the tendon footprint at the greater tuberosity. It appears to be a viable, non-prosthetic alternative to restore superior glenohumeral stability and shoulder function, even in patients with severe pseudoparalysis.