Superior Capsular Reconstruction for Massive Rotator Cuff Tears
Fortunately most rotator cuff tears are relatively small and can be repaired. However, some patients have tears that are so large that there is not enough tissue left to fix. We call these irreparable rotator cuff tears. Choosing the best surgical treatment option for these patients can be challenging. In the past the options were very limited. Surgeons might have considered doing an arthroscopic “clean up” or partial repair. More recently the reverse shoulder replacement has gained popularity, and it is a very effective option for improving function and comfort. However, a shoulder replacement option may not be the best for younger patients or individuals who are very active.
Recently, the superior capsular reconstruction has been introduced as a treatment option for younger patients with tears that cannot be repaired. In this operation a tissue graft is arthroscopically sewn in place of the missing rotator cuff. You might think of it as patching a pair of torn the jeans.
This past week we took care of a younger man, who performs manual labor. I was glad that we had an option for him other than a shoulder replacement. Here are a couple of arthroscopic images from his case. In the first picture you can see the ball and socket of the shoulder and where the rotator cuff belongs…….there is nothing! After you can see that we have arthroscopically sewn in place a graft to reconstruct the superior capsule.