Massive rotator cuff tears that have failed a previous repair or are irreparable, pose a challenge to both patients and doctors a like. The superior capsule reconstruction (SCR) offers a novel approach for these patients. Prior to SCR the treatment options included debridement, bicep release or tenodesis, partial cuff repairs, bridgeing grafts, latissmus dorsi transfers or prosthetic replacement (e.g., Reverse Total Shoulder Arthroplassty). SCR utilizes a graft that is attached to the superior glenoid, the shoulder socket, and the greater tuberosity on the humerus, the shoulder ball. The goal with SCR surgery is to help stabilize the humeral head in the glenoid. Theorectically with improved glenohumeral kinematics the deltoid and remaining rotator cuff muscles can function more effectively. With glenohumeral stabilization the risk of cartilage degeneration and progression to rotator cuff arthropathy should be decreased. Recent early follow up studies have shown promising results with decreased pain and increased function. Currently, using collagen scaffolds to bridge a gap in the rotator cuff greater then 1 cm is considered off-lable.
I recently had the privilige to assist Dr. Gus Mazzocca with a cadaveric educational lab on superior capsular reconstruction in Bergen County, NJ. Should you have any questions about this novel approach to a challenging problem, please contact Specialty Orthopaedics of New Jersey, P.A. at 201-447-1188. Dr. David P. Rudman is available to discuss SCR and other options that may benefit you, a friend or family member.
