Superior Capsular Reconstruction of the Shoulder

In order to fully understand the Superior Capsular Reconstruction, or SCR, you must first understand the shoulder joint and the role of the rotator cuff. In a healthy shoulder, the ball of the long arm bone (the humeral head) fits into the socket of the shoulder blade (the glenoid). The rotator cuff is the term used to describe the group of muscles and tendons surrounding the shoulder joint that provide stability to the joint by depressing the humeral head and allow for movement of the upper arm.

Injuries to the rotator cuff typically consist of inflammation of the tendons or a partial or full-thickness tear of a tendon or muscle in the rotator cuff. Non-invasive treatment such as ice and anti-flammatory medications can typically treat inflammatory injuries, but in same cases, a decompression surgery may be necessary to prevent friction causing ongoing inflammation. However, in some cases, the rotator cuff is deemed “irreparable.” In this circumstances, the tissue is too thin or fatty to be successfully repair surgically. Without treatment, the patient experiences limited range of motion and ongoing pain, and before superior capsulation reconstruction was recently developed, many patients did not have treatment options for the condition at all.

In cases of irreparable shoulder damage, superior capsular reconstruction is often recommended. SCR improves joint stability by prevent the humerus head from migrating upward without the rotator cuff to keep it down. During superior capsular reconstruction, a fairly robust plate or patch is attached to both the humeral head and the glenoid (the socket on the scapula, or shoulder blade) to prevent upward movement of the humerus. According to research, while the procedure does not repair or replace the rotator cuff, it provides significant relief from symptoms for most patients. Patients report decreased pain and increased mobility following the reconstruction, and ongoing observation shows no further development of arthritis in the shoulder joint. Patients who do not heal successfully from the surgery or fail to show positive results may be eligible for a reverse total shoulder replacement down the road.

Patients scheduled to have a superior capsular reconstruction surgery should expect a recovery period of three to six months, during which time they may be under restrictions from their physician, they may have to take some medications, and they may be required to complete ongoing physical therapy. A sling is typically worn for up to four weeks following the procedure and the affected arm may not be used for functional purposes for a length of time. Leave from work is typically required.

Although the procedure is fairly new, it has brought hope and a positive outcome to many patients who have been suffering from an irreparable shoulder cuff tear for which there was no previous treatment. Prior to the development of superior capsular reconstruction, patients were often limited to steroid injections in the joint, which are limited in frequency, often painful, and which provide no long-term improvement of the joint and/or rotator cuff. This procedure, on the other hand and to the relief of many patients, provides long-term improvement and relief.