Superior Capsule Reconstruction: The Italian Perspective

Arthroscopic rotator cuff repair surgery is a successful procedure with high rate of good clinical outcomes and patient satisfactions. However, treatment of massive and irreparable tears still remains a challenge. Advancements in arthroscopic techniques led to several treatment options ranging from joint-preserving procedures up to reverse shoulder arthroplasty. The best choice probably needs to be tailored not only on pathology but also on patient factors intended as general health status and functional demand as well as on surgeon’s skill and experience. Arthroscopic superior capsule reconstruction (SCR) has been recently suggested to create a superior restraint in order to recenter the humeral head, thus restoring normal shoulder function. While maintaining the basic principles, several modifications have been proposed in order to simplify the technique and reduce its costs. The aim of the following chapter is to provide an overview on indications, surgical technique, and results of arthroscopic SCR, with a specific focus on a modified technique by using the proximal portion of the autologous long head of the biceps tendon (LHBT).