Superior Capsular Reconstruction for Massive Irreparable Cuff Tears: A Systematic Review for Clinical & Functional & Radiological Outcomes

Abstract

assive rotator cuff tears (MRCT) are defined as a full-thickness tear of at least two tendons or measuring greater than five centimeters in diameter in the coronal plane. They represent about 20% of all rotator cuff tears and 80% of recurrent tears. Irreparable rotator cuff tears (IRCT) are defined as the lesions cannot be repaired primarily to their insertion on the tuberosities despite conventional techniques of surgical release/mobilization, because of their size, retraction, and muscle impairment caused by atrophy and fatty infiltration. Disruption of superior capsule results in losing its role in glenohumeral stability mechanics which is the “Reverse trampoline” effect, that prevents the humeral head from making contact with the undersurface of the acromion and migrating proximally and maintain the active glenohumeral stability. Mihata et al. was the first to demonstrate that reconstruction of the superior capsule closely mimicked subacromial pressure and translation observed with an intact rotator cuff. SCR is indicated for patients with massive irreparable rotator cuff tear with mild arthritic changes on radiographs showing a good joint space on axillary and Grashey view.