Superior Capsule Reconstruction: A Glimpse into the Future?

The recent study by Mihata et al., [10] “Five-year follow-up of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears” (J Bone Joint Surg Am. 2019;101:1921–1930), was the first case series published examining long-term clinical and radiographic outcomes of superior capsule reconstruction (SCR) for irreparable rotator cuff tears. This article is a critical review of how the aforementioned study fits into a growing literature surrounding the use of SCR for irreparable rotator cuff tears and how these results may impact clinical and operative decision-making for this patient population. The series compares clinical and radiographic data taken pre-operatively with data taken at 1 year and 5 years post-operatively in a group of 30 patients who underwent SCR utilizing tensor fascia lata autograft. While the results of the study suggest that a healed SCR graft utilizing this specific technique successfully restored shoulder function and prevented progression of rotator cuff arthropathy, it is important to appreciate the limitations of this small, retrospective case series. Nonetheless, the study represents an important addition to the expanding literature surrounding this significant topic. In this report, we shed light on the current state of this novel operative technique and the ongoing controversies revolving around graft material and thickness.