AOSSM/AANA Specialty Day 2020-Results Justify

Video Transcription

Video Summary

Dr. JT Tokish from Mayo Clinic Arizona discusses Superior Capsular Reconstruction (SCR) for treating massive irreparable rotator cuff tears. Traditional options like debridement or reverse shoulder arthroplasty (RSA) offer pain relief but limited functional improvement, especially in younger patients, with RSA showing a 25% failure at three years. SCR, introduced by Terry Mihata, involves grafting fasciae latae tissue to restore shoulder stability, yielding promising results with ASES scores improving from 31 to 93 and forward elevation near 150 degrees. However, graft healing is variable, with failures often occurring on the humeral side, and thicker grafts (8mm) outperform thinner allografts (3mm). Dr. Tokish’s team uses enhanced techniques including triple glenoid anchors and integrating residual cuff tissue to improve outcomes. They also developed an "SCR Plus," augmenting graft thickness by resurfacing the acromion. Proper patient selection, avoiding advanced arthritis and irreparable subscapularis tears, is critical. Overall, SCR is a game-changing but evolving procedure requiring further biological advances for durable healing.

Keywords

Superior Capsular Reconstruction

massive irreparable rotator cuff tears

rotator cuff repair

graft thickness

shoulder stability