Q&A Topic: A New Solution for Massive Rotator Cuff Tears — Superior Capsular Reconstruction

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Evan H. Karas, MD, FAAOS


Q. What are symptoms of typical rotator cuff injury?

A. If you’re experiencing any of the following symptoms, it’s important to have your shoulder checked out by an orthopedist. Pain while lifting or lowering your arm, or with specific arm and shoulder movements. Weakness when lifting or rotating your arm, especially when reaching for something behind your back, such as combing your hair or scratching a back itch. A popping sound or tearing sensation in your shoulder.

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Q. What is Arthroscopic Superior Capsular Reconstruction and how is it used to help individuals with old rotator cuff tears?

A. Left untreated, rotator cuff tears become degenerative – meaning they worsen over the years. If you’ve left the tear untreated, your rotator cuff will ultimately retract, or pull away from its normal attachment site on the ball of the shoulder. If this happens, the rotator cuff may have irreversible damage and tissue loss due to the muscle not being used for a long time. However, Arthroscopic Superior Capsular Reconstruction treats these massive, once irreparable rotator cuff tears and gives hope to those who’d like to restore shoulder stability, improve shoulder function and get relief from pain. Arthroscopic Superior Capsular Reconstruction is a wonderful option for patients who are active, healthy and functional and have a massive rotator cuff injury that has not progressed to arthritis.

Q. How does this procedure work?

A. Every effort is made to completely repair your rotator cuff. However, if your tissue quality isn’t optimal and we can’t repair it, Arthroscopic Superior Capsular Reconstruction gives you a promising option you didn’t have before. A soft tissue graft from a cadaver replaces, rather than repairs, any missing tendons you may have in your shoulder.

Q. What are the benefits?

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A. The biggest benefit is that this procedure could allow you to get back to doing the things you love. Whether it’s swimming, golfing, or tennis, I’ve seen life-changing results. I see many patients with chronic rotator cuff tears who have been told by other doctors that there is nothing else that can be done for their shoulder. With this procedure, there’s now hope of a solution that improves range of motion and eliminates pain.

Q. How long is the recovery time?

A. The goal of this procedure is to restore your function and eliminate your pain. It’s important to speak with your physician about the healing process. For my patients – I break it up into two phases. The first phase of healing is six weeks and is crucial to ensure the best possible result. You’ll wear a sling to restrict movement and avoid stress on the graft. You’ll be performing passive range of motion exercises. The second phase involves gently easing into strengthening the shoulder as the graft continues to heal.

Learn More About Dr. Karas

Co-Chief, Orthopedic Surgery
Co-Director, Orthopedic & Spine Institute
Northern Westchester Hospital

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Northern Westchester Hospital is a proud member of Northwell Health.

Read Past Topics from Dr. Karas: 
Shoulder Pain and Advanced Shoulder Surgery
Boning Up On A Common Knee Injury
Managing Arthritis in the Knee
Sports-Related Shoulder Injuries


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