Superior capsular reconstruction

Operation Information and Rehab Information
Most rotator cuff tears can be repaired with excellent results. However in longstanding very large tears it may be that either the tendon cannot reach its attachment site or that the tendon or muscle quality is so poor that there is no chance that the repair can succeed.

These ‘irreparable’ rotator cuff tears are therefore a difficult problem. A theoretically good option would be to attach a patch between the tendon end and the bone to bridge the gap in the tendon. Unfortunately because the muscle quality deteriorates after a large rotator cuff tear the longterm results of this procedure are quite poor. Other operations such as debridement and subacromial decompression, partial repair, tendon transfers, and reverse total shoulder arthroplasty have been utilised but all have inferior outcomes to rotator cuff repair.

Superior capsular reconstruction (SCR) is a relatively new technique that was developed by Dr Teruhisa Mihata in 2007. This operation is a potential option for patients who have previously been told their rotator cuff is irreparable.

The superior shoulder capsule is a thin structure that is attached to the upper border of the glenoid (the socket of the shoulder joint) and the greater tuberosity of the upper humerus (the arm bone). It plays an important role in stabilising of the shoulder joint preventing the humeral head form migrating upwards. The superior capsule is always torn in large rotator cuff tears.

The SCR does not rely on the muscle to create movement and therefore the muscle deterioration does not adversely affect the outcomes.

Reconstruction of the superior capsule, and consequently, stabilisation of the glenohumeral joint allows the remaining rotator cuff to produce movement and leads to improvement in terms of function and pain relief.

While this technique is new, the early clinical results are very encouraging and it is likely to represent a significant improvement on the techniques that have previously been available.

(02) 9587 4720

Sydney Orthopaedic Trauma and Reconstructive Surgery
Suite 5, Level 2
19 Kensington Street
Kogarah NSW 2217