2021 Annual Meeting Shoulder Access Pass-Panel Discussion: During Surgical Technique Spotlight - Superior Capsule Reconstruction with Dermal Graft (video)

Panel Discussion: During Surgical Technique Spotlight - Superior Capsule Reconstruction with Dermal Graft (video)

Video Transcription

Video Summary

This discussion focuses on the technical nuances of superior capsule reconstruction (SCR) for chronic rotator cuff tears. The panel emphasizes patient positioning (beach chair preferred), portal placement, and careful handling of the biceps tendon—often used as graft extension if available. A functional or repairable subscapularis is considered essential for SCR success. Necromyoplasty and subacromial decompression are commonly performed to aid visualization and healing, assuming good cuff containment. The experts caution against pulling grafts through anchors to avoid anchor failure and favor knotless anchor constructs. Precise graft measurement and tensioning (often at 20–30 degrees of abduction) are vital, with suture management critical to avoid entanglement during graft passage. Dermal allografts are common, though some use hamstring grafts for better thickness. Post-fixation, lateral row anchors secure the graft, followed by interval closures to restore cuff balance and prevent superior escape. Rehabilitation is slow, with sling immobilization for six weeks and delayed strengthening up to 12–16 weeks.

Asset Caption

Christopher Camp, MD; Alan Curtis, MD; Scott Trenhaile, MD

Keywords

superior capsule reconstruction

chronic rotator cuff tears

patient positioning beach chair

biceps tendon graft

dermal allografts