Superior Capsular Reconstruction
A Joint Preserving Alternative to Joint Replacement for Patients with Large to Massive Rotator Cuff Tears
What is Superior Capsular Reconstruction (SCR)?
SCR is a technique for shoulder joint preservation. It treats very large to massive rotator cuff tears that cannot be primarily repaired. The original technique was developed in Japan and used the patient's own tissue to bridge the defect from the glenoid (socket) to the humeral head (ball).
Recent techniques in North America are using allograft (donated tissue) instead of harvesting tissue from the patient. This allows for a thicker and more uniform graft
Who is Superior Capsular Reconstruction (SCR) for?
SCR is designed for patients with very large to massive tears that cannot be repaired.
This if often a patient that has had prior repairs that have continued to re-tear or fail the repairs
This can be a patient who has lived with a rotator cuff tear for a long period of time and the tendon tear has retracted and scarred down preventing a normal repair.
Who should NOT have a Superior Capsular Reconstruction?
Patient who has rotator cuff tears that can be repaired should have their own tissue repaired. Please see our page on Rotator Cuff Tears for further details.
Patients who have developed shoulder arthritis in addition to the tear should NOT have the SCR procedure. They should consider reverse shoulder replacement if they have disabling pain.
How is Superior Capsular Reconstruction Performed?
SCR is performed in a minimally invasive fashion using multiple small portals to access the shoulder joint.
The patient's tendon tear assess to confirm that it cannot be repaired primarily and then the dimensions of the tear defect are obtained.
The graft is then measured and cut to size and then attached on both glenoid and the humeral head.
The graft is then attached to any remaining rotator cuff tendon tissue
What is the recovery like after SCR?
The surgery is an outpatient procedure but requires a long period of time for complete healing. The patient should expect to be in a sling for at least 6 weeks and plan for 12-16 weeks of post-operative rehabilitation. Patients continue to improve up to 1 year after surgery
What are the results of SCR?
The largest and longest follow up is from Japan where Dr. Mihata (who pioneered the procedure) has followed over 100 patients for 1-8 years. He demonstrated greater than 90% healing of the graft and significantly improved function (range of motion) and significant pain reduction in these patients.
Shorter follow up studies are now available in the United States using allograft (donated tissue) and also have similar early results.
Arthroscopic Superior Capsular Reconstruction With Acellular Dermal Allograft for the Treatment of Massive Irreparable Rotator Cuff Tears: Short-Term Clinical Outcomes and the Radiographic Parameter of Superior Capsular Distance.