Rotator Cuff Tears: Superior Capsular Reconstruction Using a Biologic Skin Graft Animation

Rotator Cuff Tears: Superior Capsular Reconstruction Using a Biologic Skin Graft Animation

This animation demonstrates a superior capsular reconstruction of the shoulder joint using a biologic skin graft for the treatment of a rotator cuff tear. A superior capsular reconstruction is used to treat a massive rotator cuff tear that cannot be repaired. It is usually used in patients who have minimal to no arthritis in the ball and socket joint.

This surgical technique uses a skin graft to connect the shoulder blade and upper arm bone together, where the rotator cuff tendon has torn off from the bone. This helps stabilize the shoulder joint to decrease pain and allow for better movement of the arm. Here we see a right shoulder with the front of the shoulder facing the right side of the screen. Surgical instruments will be passed through a plastic tube called a cannula. That is inserted into the shoulder to perform the procedure.

The top of the upper arm bone, or humerus, and socket portion of the shoulder blade, or scapula, are first shaved down. Next, 3 anchors are inserted into the top of the shoulder socket, and 2 anchors are inserted into the top of the upper arm bone. These anchors are already threaded with sutures. A surgical guide is used to mark the distance between the anchors. These measurements are used to size the skin graft, so it fits appropriately.

The sutures from the 2 anchors in the upper arm bone are pulled out of the shoulder through the cannula and threaded through the bottom of the graft. The sutures from the 3 anchors in the shoulder socket are threaded through the top of the graft and used to help pull the graft into the shoulder. Applying tension to these three strands secures the top of the graph to the shoulder socket to fix it in place.

Next, the other end of the graft is secured to the upper arm bone through a double-row repair using 2 additional anchors. Additional small sutures are added in the front and back of the graft to secure it to the remaining rotator cuff. The superior capsular reconstruction is now complete.