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Maria E Dey Hazra, Rony-Orijit Dey Hazra, Jared A Hanson, Phob Ganokroj, Matthew L Vopat, Joan C Rutledge, Kohei Yamaura, Sunikom Suppauksorn, and Peter J Millett

  • While functional reconstruction of massive irreparable rotator cuff tears remains a challenge, current techniques aimed at recentering and preventing superior migration of the humeral head allow for clinical and biomechanical improvements in shoulder pain and function.

  • Recentering of the glenohumeral joint reduces the moment arm and helps the deltoid to recruit more fibers, which compensates for insufficient rotator cuff function and reduces joint pressure.

  • In the past, the concept of a superior capsular reconstruction with a patch secured by suture anchors has been used.

  • However, several innovative arthroscopic treatment options have also been developed.

  • The purpose of this article is to present an overview of new strategies and surgical techniques and if existing present initial clinical results.

  • Techniques that will be covered include rerouting the long head of the biceps tendon, utilization of the biceps tendon as an autograft to reconstruct the superior capsule, utilization of a semitendinosus tendon allograft to reconstruct the superior capsule, superior capsular reconstruction with dermal allografts, and subacromial spacers.

Rui Claro and Hélder Fonte

. Concomitant procedures Margin convergence or side-by-side repair is another commonly performed procedure, concomitant with SCR ( 32 ). This procedure involves repairing the posterior margin convergence only (remnant of infraspinatus or teres minor) or

Alexandre Lädermann, Stephen S. Burkhart, Pierre Hoffmeyer, Lionel Neyton, Philippe Collin, Evan Yates, and Patrick J. Denard

plane and typically require margin convergence to achieve complete repair. Finally, massive contracted tears have also been described. These tears have limited medial-to-lateral and anterior-to-posterior mobility and typically require advanced