Superior Capsule Reconstruction
A surgical procedure to restore shoulder stability and function after irreparable rotator cuff tears
Superior capsule reconstruction involves using a graft to stabilise the shoulder joint and restore its function.
Common Reasons for Surgery
- Chronic shoulder pain and instability due to massive rotator cuff tears.
- Loss of shoulder function affecting daily activities and work.
- Failure of previous treatments, such as physiotherapy or injections.
Goals of the Procedure:
- Restore shoulder stability by reconstructing the superior capsule.
- Reduce or eliminate shoulder pain.
- Improve range of motion and strength for better daily function.
Preparation for Surgery
Proper preparation helps to ensure a smooth surgical experience and optimal recovery.
Steps in Preparation:
- Pre-Surgical Consultations and Imaging:
- Dr Ben McGrath will assess your shoulder using physical exams, X-rays, and MRIs to confirm suitability for superior capsule reconstruction.
- Optimising Health:
- Smoking cessation, maintaining a healthy weight, and engaging in prescribed prehabilitation exercises may improve outcomes.
- Pre-Surgical Instructions:
- Follow fasting guidelines provided before the procedure.
- Review medications with Dr McGrath to identify those that should be paused or adjusted.
What Happens During the Surgery?
The procedure is performed under anaesthesia and uses minimally invasive arthroscopic techniques whenever possible.
Surgical Steps:
- Anaesthesia:
- General anaesthesia is used to ensure patient comfort.
- Preparation of the Shoulder:
- The damaged shoulder capsule is prepared for graft placement.
- Placement of the Graft:
- A biologic graft is secured to the shoulder using sutures and anchors, reconstructing the superior capsule and restoring joint stability.
- Final Steps:
- The surgical area is closed, and a dressing is applied.
The procedure typically takes 2–3 hours, depending on the complexity.
Understanding the Risks
All surgeries carry some risks, and superior capsule reconstruction is no exception.
Common Risks:
- Temporary shoulder stiffness.
- Bruising or swelling around the surgical site.
Rare but Serious Risks:
- Graft failure or loosening.
- Nerve or blood vessel injury.
Dr McGrath will take every precaution to minimise these risks and will discuss them in detail during consultations.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain management with prescribed medications.
- Use of a sling to immobilise the shoulder and protect the repair.
- Specific instructions for wound care and activity restrictions.
Discharge Instructions:
- Guidelines on showering, medications, and follow-up appointments.
- Restrictions on shoulder use to allow proper healing.
Rehabilitation and Recovery
A structured rehabilitation program is critical for successful recovery.
Phase 1: Protection and Healing (Weeks 0–6):
- Focus: Allow healing and reduce inflammation.
- Activities: Passive range-of-motion exercises guided by a physiotherapist.
Phase 2: Strengthening (Weeks 6–12):
- Focus: Gradual improvement of strength and mobility.
- Activities: Controlled exercises to regain flexibility and prevent stiffness.
Phase 3: Functional Recovery (Months 3–6):
- Focus: Restoring shoulder function for daily activities.
- Activities: Progressive resistance training and returning to work or recreational activities.
Long-Term Outcomes
Superior capsule reconstruction is often recommended for patients with chronic rotator cuff injuries to improve shoulder stability and function.
Expected Improvements:
- Pain relief and improved shoulder stability.
- Enhanced ability to perform daily activities.
- Increased range of motion and strength.
Maintenance of Results:
- Commitment to physiotherapy and rehabilitation exercises.
- Regular follow-up with Dr McGrath to monitor progress.
- Avoiding activities that may strain the shoulder during recovery.