Rotator cuff tear is a common yet functionally debilitating shoulder condition. Risk factors for failure of repair or inability to repair include advancing age of the patient, chronicity of the tear, and larger tear size. Current operative management options for tears that are considered irreparable include debridement, partial repair, biceps tenotomy, interpositional grafting, tendon transfers, and reverse shoulder arthroplasty. Recently, superior capsular reconstruction has been introduced as an alternative surgical option for these tears and has demonstrated favorable short-term outcomes. However, the literature lacks studies with large numbers of patients, consistency of results, and long-term outcomes. This article reviews the anatomy and function of the rotator cuff and shoulder capsule; patho-etiology of rotator cuff tears, particularly the irreparable ones; and rationale, techniques, outcomes, and future direction of superior capsular reconstruction in the context of this clinical indication.
Part of the book: Advances in Shoulder Surgery