When is Superior Capsular Reconstruction Surgery Utilized?
In rotator cuff repair surgery, a torn rotator cuff tendon is surgically mobilized and then anchored to its normal bony attachment site. However, some patients present having severely torn most or all of their rotator cuff tendons. These massive tears did not happen overnight. These massive rotator cuff tears are severely retracted from where the tendon normally attaches. These massive tears are usually “acute on chronic” tears, wherein a patient has had a rotator cuff tendon tear and often never knew it as they lost strength very slowly over time and were able to compensate. However, usually there is then a small incident, such as a ground level fall, where the patient tears away some remaining tendon and the patient can no longer compensate. These patients present with severe shoulder pain and weakness. Many patients cannot even lift their arm overhead. An MRI of the shoulder often shows most of the rotator cuff tendons to be torn. Moreover, the supraspinatus (rotator cuff tendon on the top of the shoulder) is often severely retracted from its normal attachment site, being pulled back 3 inches or so. Historically, nothing could be done for these severely retracted supraspinatus tears as they would not stretch back to where they belong, and a surgeon could only repair those tendon tears that could be adequately mobilized and reattached to their attachment site. However, Superior Capsular Reconstruction (SCR) is a newer shoulder surgical technique that Dr. Cunningham has utilized in many patients who had a massive, severely retracted supraspinatus and/or infraspinatus rotator cuff tear that was not repairable.