Arthroscopic superior capsular reconstruction of the shoulder: a narrative review

Abstract

Irreparable rotator cuff tears (IRCTs) in young and considerably active patients are difficult to treat because it is mostly associated with poor outcome which may lead to a painful and dysfunctional shoulder. Most of the IRCTs are encountered in massive size rotator cuff tears which associated with high failure rate following surgical repair. Thus, the IRCTs was considered challenging for its poor healing rate following repair which may induce the arthritic changes. Since the advent of arthroscopic superior capsular reconstruction (ASCR) of the shoulder in 2013, it has gained its popularity. The procedure has become the most popular option for joint-preserving shoulder surgery for patients with IRCTs. It works by providing a static restraint to the superior humeral head migration to optimize the rotator cuff force couples, hence improving joint kinematics. The acceptance of superior capsular reconstruction has made it rapidly evolving in terms of a wider variety of procedures and broader surgical indications. Despite the enthusiasm and widely acceptance towards the procedure, there are still many queries that exist regarding the best indications, surgical technique particularly graft of choice, the long-term outcome, and the complication and risk of the superior capsular reconstruction (SCR). This narrative review provide the current evidence of SCR in an attempt to provide a state-of-the-art knowledge.

A method for the treatment of patients with massive tears of the rotator cuff: a clinical case

“…Авторы сообщали о благоприятных результатах, а именно о снижении болевого синдрома и увеличении объема движений поврежденного сустава, однако в 16,7% случаев были отмечены отрывы трансплантата, частота которых, по данным литературы, составляет от 10 до 12,9%. Описаны также случаи повторных проксимальных подвывихов головки плечевой кости в результате растяжения трансплантата и последующего его отрыва [5][6][7].…”

Bilateral Arthroscopic Superior Capsular Reconstruction of the Shoulder for Irreparable Rotator Cuff Tears: A Case Report and Description of Surgical Technique

“…Likewise, patients with subscapularis tears unless the subscapularis can be restored at the time of the surgery [ 5 ]. Finally, patients with significant medical comorbidities or inadequate bone quality, as well as those reluctant to adhere to post-surgical treatment conditions, are not ideal candidates for SCR [ 6 ].…”

Early Postoperative MRI Evaluation of a Fascia Lata Autograft With and Without Polypropylene Mesh Augmentation After Superior Capsular Reconstruction

“…2-0 polyester suture (Ethibond; Ethicon) was used to seal the graft margin (Figure 2). 19 The graft was fixed at the glenoid site using 3 suture anchors (JuggerKnot, 2.5 mm; Zimmer Biomet or Helicoil, 4.5 mm; Smith & Nephew) and at the humeral site with 2 polyetheretherketone (PEEK) threaded anchors (Helicoil, 4.5 mm; Smith & Nephew) for medial row fixation using a double-row suture bridge construct. The over-the-top technique was performed to fix the remaining bursal tissue.…”

“…All patients initiated strengthening exercises after being prescribed a shoulder abduction brace for 6 weeks after surgery. 19…”