Superior Capsular Reconstruction

Dr. Ronak M. Patel, a double board-certified and fellowship-trained orthopedic surgeon specializing in sports medicine injuries and shoulder conditions, offers advanced treatment options for patients dealing with severe rotator cuff tears. One of these innovative procedures is Superior Capsular Reconstruction – a surgical technique designed to restore shoulder function and relieve pain when a rotator cuff tear cannot be repaired.

What is Superior Capsular Reconstruction?

The rotator cuff is a group of muscles and tendons that help keep your shoulder stable and allow smooth movement. When these tendons are torn, they can cause significant pain, weakness, and limited mobility. In some cases, especially when the tear is too large or the tendon is too damaged to be stitched back together, standard rotator cuff repair is not possible.

Superior Capsular Reconstruction is a surgical procedure that addresses this issue by using a graft—either from the patient’s own tissue or from a donor—to reconstruct the superior capsule, a key structure that helps maintain the proper position of the humerus within the socket. The graft is used to replace the damaged rotator cuff tendon. The graft acts as a cushion and helps to keep the ball of the shoulder joint in place, preventing it from moving too high and causing further damage.

When is Superior Capsular Reconstruction recommended?

Superior capsular reconstructionn is designed to treat massive rotator cuff tears to provide reliable pain relief and restore good function. This technique is particularly beneficial for patients who have not found relief through non-surgical treatments and wish to avoid more extensive surgeries like shoulder replacement.

Superior capsular reconstruction is typically recommended for patients with:

• Massive irreparable rotator cuff tears, when the tendon is too damaged or retracted to be repaired.
• Chronic shoulder pain and weakness, that does not improve with physical therapy, injections or other conservative treatments.
• Loss of shoulder function, making it difficult to lift the arm or perform daily activities.
• Experience no improvement with conservative treatments such as physical therapy or medications.
• When there is no advanced arthritis in the shoulder joint and the patient wishes to preserve their natural shoulder joint and avoid joint replacement surgery.
• This is an excellent for younger, active patients who desire to avoid more invasive shoulder surgery.

What is the procedure?

Dr. Patel performs superior capsular reconstruction as a minimally invasive arthroscopic procedure, meaning it is done through small incisions using a camera and specialized instruments. The key steps of the surgery include:

1. Preparing the Shoulder Joint – Any damaged tissue or bone spurs are removed to create a stable foundation for the graft.
2. Placing the Graft – A graft, often made from donated human tissue, is positioned where the rotator cuff tendon is missing.
3. Securing the Graft – The graft is anchored to the shoulder using strong stitches and small implants to hold it in place.
4. Allowing the Graft to Heal – Over time, the graft integrates with the surrounding tissue, restoring shoulder stability.

The procedure helps reposition the shoulder joint properly, reducing pain and improving movement.

Recovery and Rehabilitation

Recovery from superior capsular reconstruction involves a structured rehabilitation program:

• Immobilization: Initially, the shoulder is kept in a sling for about six weeks to protect the repair.
• Passive movements: Gentle, assisted movements are started to maintain flexibility without straining the repair.
• Active movements: Gradually, patients begin to use their shoulder actively, restoring range of motion.
• Strengthening exercises: Strength training is introduced to rebuild muscle and improve shoulder stability.

Full recovery can take several months, with many patients returning to their regular activities within 8 to 12 months. Adherence to the rehabilitation plan is crucial for a successful outcome.

Dr. Ronak M. Patel’s Expertise

Dr. Ronak M. Patel is a double board-certified orthopedic surgeon specializing in sports medicine and shoulder injuries at Hinsdale Orthopedics in Chicagoland, the Tri-State areas, across the US and internationally. With extensive training and experience, Dr. Patel is proficient in performing advanced procedures like Superior Capsular Reconstruction. He is dedicated to providing personalized care, utilizing the latest surgical techniques to help patients regain function and return to their daily activities. For more information or to schedule a consultation with esteemed Dr. Ronak M. Patel today. You will always be treated with dignity and respect.

References

• Claro R, Fonte H. Superior capsular reconstruction: current evidence and limits. EFORT Open Rev. 2023 May 9;8(5):340-350. doi: 10.1530/EOR-23-0027. PMID: 37158430; PMCID: PMC10233801.