Arthroscopic Superior Capsular Reconstruction for Massive Irreparable Rotator Cuff Tears Results in Significant Improvements in Patient Reported Outcomes and Range of Motion: A Systematic Review

Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing

“…In addition to the superior capsular reconstruction (SCR) with the long head of the biceps tendon (LHBT), we performed a tension-free double-row repair of the supraspinatus and of the subescapularis if it is also injured. As other authors have published 14 , 15 , 16 and as is also our experience, by reinforcing the cuff suture using the long head of the biceps, we improve both the biomechanics and the biology of the repair and decrease the rate of retears.…”

“…The SCR with the LHBT is really a booster for the supraspinatus repair, both from the biomechanical and biological point of view; we create a superior static stabilizer, to try to reduce the rate of cuff retears and achieve a better clinical progression that lasts over time. 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 We follow the Mihata technique also for the fixation of the LHBT at the greater tuberosity in 30° of abduction, which is the optimal position for graft fixation and tension. 22 , 23 …”

“…We might think that this technique could produce postoperative pain associated with the use of the LHBT, since it is a pain generator, but in our experience, which coincides with other authors’ experiences, this is not a real problem that appears. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 30 There are risks associated with LHB tenotomy, such as the appearance of Popeye’s sign or cramps, although over time, they rarely represent a functional problem in patients. 27 , 28 …”

“…Some authors have used this technique in irreparable massive tears as an isolated technique, or combined with partial repairs of the rotator cuff. 12 , 13 , 14 , 15 , 16 …”