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Review
. 2023 May 9;8(5):340-350.
doi: 10.1530/EOR-23-0027.

Superior capsular reconstruction: current evidence and limits

Rui Claro  1   2   3   4   5 , Hélder Fonte  6   4   5   7
Affiliations
Review

Superior capsular reconstruction: current evidence and limits

Rui Claro et al. EFORT Open Rev. .

Abstract

The treatment of rotator cuff tears (RCTs) has evolved. Nonsurgical treatment is adequate for many patients; however, for those for whom surgical treatment is indicated, rotator cuff repair provides reliable pain relief and good functional results. However, massive and irreparable RCTs are a significant challenge for both patients and surgeons. Superior capsular reconstruction (SCR) has become increasingly popular in recent years. It works by passively restoring the superior restriction of the humeral head, thus restoring the pair of forces and improving the kinematics of the glenohumeral joint. Early clinical results using fascia lata (FL) autograft were promising in terms of pain relief and function. The procedure has evolved, and some authors have suggested that FL autografts could be replaced by other methods. However, surgical techniques for SCR are highly variable, and patient indications remain undefined. There are concerns that the available scientific evidence does not support the popularity of the procedure. This review aimed to critically evaluate the biomechanics, indications, procedural considerations, and clinical outcomes associated with the SCR procedure.

Keywords: dermal allograft; fascia lata; massive and irreparable; restoring the pair of forces and improving the kinematics; rotator cuff tears; superior capsular reconstruction.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Figure 1
Figure 1
Intraoperative arthroscopic view. (a) The anterior rim of the glenoid; Glen, the superior border of the glenoid and (b) the posterior rim of the glenoid; IS, infraspinatus.
Figure 2
Figure 2
Intraoperative arthroscopic view of the superior part of the glenoid. (a) anterior anchor and (b) posterior anchor.
Figure 3
Figure 3
Medial fixation of the graft over the glenoid. (a) anterior and (b) posterior.
Figure 4
Figure 4
Concomitant side-by-side suture of the graft with the infraspinatus. (a) anterior border of the graft; (b) infraspinatus; and (c) side-by-side suture of the graft with the anterior part of the infraspinatus.
See this image and copyright information in PMC

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