Superior capsule reconstruction

Superior capsule reconstruction (SCR) is a relatively new advancement in the realm of treating irreparable rotator cuff tears (RCTs). The surgery involves anchoring a graft between the superior glenoid and greater tuberosity, with the goal of restoring the continuity of the capsule and mechanical balance of the glenohumeral joint. Although the body of evidence surrounding SCR is in its infancy, it has been shown to be biomechanically superior to patch grafting procedures. Additionally, it provides the advantage over tendon transfers in that it does not burn bridges for subsequent interventions. A series of high-level biomechanical studies, which are highlighted in this review, have provided helpful information for the evolution and refinement of the SCR technique, including the importance of side-to-side suturing of the graft with the remnant cuff as well as the utility of concomitant acromioplasty. Early clinical results are promising for SCR, with both strong objective and subjective outcomes.