Superior Capsular Graft Augmentation of Massive Rotator Cuff

Superior Capsular Reconstruction with Graft Augmentation

The rotator cuff is a group of four muscles that run from the scapula (shoulder blade) and attach to the humeral head (top of upper arm bone) by their tendons. When the rotator cuff is torn and left untreated for an extended period of time, the tendon retracts away from its attachment point and the muscle atrophies and degenerates (shrinks, weakens, and irreversibly turns to useless fat and scar tissue). This makes the repair technically more difficult and in some cases impossible. In these cases, an alternative method of repair is utilized. When one of the rotator cuff tendons, specifically the supraspinatus, is largely retracted and unrepairable, reconstruction of the superior capsule of the glenohumeral (shoulder) joint with either an iliotibial band tendon (patient’s own tendon along the lateral thigh) autograft or a dermal allograft (thick cadaver skin).

Dr. Chudik approaches rotator cuff tears arthroscopically through small incisions (arthroscopic portals). The surgery is generally performed as outpatient surgery (you go home the same day). Dr. Chudik uses the small incisions to look in the shoulder joint with a camera and special instruments are used to identify, release, mobilize and repair as much of the rotator cuff as possible. If a large portion of the supraspinatus portion of the rotator cannot be prepared, either an iliotibial band autograft from the thigh or a dermal allograft (sterilized donor tissue) is prepared and inserted into the shoulder through arthroscopic portals. The graft is then attached across the top of the glenohumeral joint from the glenoid (socket) to the humerus (upper arm bone). Sutures and anchors secure the graft in place until it heals to the bone gradually over four to six months