SHOULDER – COMPLEX CASE
Upper capsular reconstruction (UCR)
Superior capsular reconstruction is an arthroscopic procedure performed to treat certain massive and irreparable tears of the rotator cuff, particularly of the supraspinatus tendon. It involves securing a tendon or fascial graft between the glenoid cavity and the humeral head in order to re-centre the shoulder and limit the upward displacement of the humerus.
The aim is to reduce pain, improve shoulder function and delay the progression to osteoarthritis or the need for a shoulder replacement.
Post-operative care requires immobilisation followed by gradual rehabilitation over several months.
The clinical results are generally encouraging, but some studies have shown non-negligible rates of graft rupture or failure. For similar indications, reconstruction of the supraspinatus using an allograft of fascia lata attached to the scapula and humerus now appears to be a promising alternative, offering a more anatomical reconstruction and potentially greater reliability in the medium term.