A torn rotator cuff is one of the most common of sports injuries. People who are most at risk are those who play sports where they have to forcefully move their arm overhead, such as swimmers and volleyball, softball and tennis players. A torn rotator cuff usually responds to rest, physical therapy and surgery if it is severe. However, sometimes the injury is so massive that the more commonplace therapies don’t work. This is also true if the injury is not seen to when it occurs and the athlete decides to play through their pain or just ignore their discomfort. 

About the Shoulder
To understand a torn rotator cuff, it helps to understand the anatomy of the shoulder. The rotator cuff is not one element but a group of tendons and muscles that wrap around the upper arm bone. They help keep the shoulder stable. When these muscles or tendons are torn, sprained or inflamed, it results in a rotary cuff injury.

One surgery that may help an irreparably torn rotator cuff is through a technique called superior capsular reconstruction. This is a surgery that uses a skin graft donated either by the patient or from a cadaver.

About the Reconstruction Surgery
The best candidates for superior capsular reconstruction are people with irreparable tears of shoulder muscles known as the supraspinatus and/or the infraspinatus. The former is found just above the spine of the shoulder blade at the back and attaches it to the upper arm bone. It helps the upper arm move away from the body. The infraspinatus muscle is one of the muscles that make up the rotator cuff. A candidate should not suffer from arthritis in the shoulder, and their deltoid muscle, a triangular muscle with round corners that makes up the “fat” of the upper arm and the shoulder, should be intact.

The surgery can be an open operation or can be performed arthroscopically. This uses smaller incisions, miniaturized tools and a fiber optic cable attached to a monitor to guide the surgeon. If it is done this way, the risks of surgical and post-surgical complications are lessened, as is the recovery period. 

The patient reclines in a chair while the doctor raises their glenohumeral joint, one of the two great joints that form the shoulder and attempts to repair as much of the torn rotator cuff as they can. They then prepare the area for the skin graft. After the graft is inserted and anchored, the doctor sutures it in place. This surgery helps to stabilize the glenohumeral joint and keeps the head of the arm bone from slipping. This helps ease both disability and pain.

After the operation, the affected shoulder is immobilized in a sling, though gentle physical therapy often begins the day after the surgery. The shoulder is kept immobile for about month and half, then more intense forms of therapy and exercise are introduced. They continue at least until the patient has a good range of motion in their shoulder and is free of pain.