Superior Capsular Reconstruction

Superior Capsular Reconstruction

What is the Rotator Cuff?

The rotator cuff is a group of muscles and their tendons that cover the head of the humerus (the upper arm bone). They work together to stabilize the shoulder, keep the shoulder in its socket and provide the ability to rotate and lift the arm.

Rotator Cuff Tears

Tendon tears may partially or fully detach from the upper arm bone. Rotator cuff tears cause pain when lifting or lowering the arm, or with certain specific arm and shoulder movements, and shoulder weakness. ASCR may be recommended for massive rotator cuff tears that cannot be repaired by traditional shoulder surgery.

What is a massive rotator cuff tear?

Massive rotator cuff tears involve at least two tendons and compromise normal shoulder mechanics, as well as pain. Massive rotator cuff tears account for 40% of all rotator cuff tears. If not treated in a timely fashion, muscle atrophy can result in irreparable tears. Traditional repair surgery for massive tears has a high failure rate.

Nonsurgical treatment can lead to osteoarthritis. Older patients with massive tears and severe osteoarthritis can be treated with a reverse shoulder replacement. However, total shoulder replacement is not recommended for younger patients with massive tears due to concerns about implant longevity, and accompanying activity restrictions.


Rotator cuff strength is assessed with range of motion testing. Imaging studies including x-rays and MRI will reveal the status of the rotator cuff and tears.

Arthroscopic superior capsule reconstruction

ASCR is surgery that provides for the successful return to the activities of daily living and improves quality of life.

ASCR is a new option to treat irreversible rotator cuff damage caused by massive tears and tissue loss due to muscle atrophy in patients with no, mild or moderate arthritis:

  • when the tendons can no longer be repaired because there is not enough tissue left to repair
  • when an old rotator cuff tear is so badly frayed that it cannot be repaired
  • for chronic tearing after reconstruction surgery

ASCR is safe and effective to restore shoulder stability, mobility and function and pain relief.

It is the best choice for patients who are active and healthy and have massive rotator cuff tears and only mild to moderate shoulder OA.

The procedure is a minimally invasive surgery to debride the tendons (clean and remove dead tissue) and anchor the tendons back to the bone, using an allograft (skin graft from a cadaver) to patch and repair the rotator cuff capsule.

Arthroscopic superior capsular reconstruction is an outpatient procedure. Post-surgical rehabilitation is similar to that required after rotator cuff repair and is designed to protect the surgical repair, minimize pain and inflammation and to maintain mobility. Full function is restored within three months.

ASCR is a new option to repair irreversible damage and loss of tissue which were once considered to be irreparable. ASCR can be life changing allowing you to return to the life you love and the activities you enjoy including golf, tennis and swimming.

ASCR is a complex procedure that requires specialized technical skills performed by a team of specialists experienced in this procedure. Ortho Illinois offers board-certified, fellowship-trained orthopedic surgeons with the expertise required to perform this highly technical procedure.  We provide an unsurpassed continuum of care by a team of surgeons, physiatrists and physical and occupational therapists focused on your successful surgery and recovery. Ortho Illinois has offices in Algonquin, Elgin, and  Rockford for your convenience. Contact us to schedule a consultation and the right diagnosis and treatment.