The "Pull-Over" Technique for Arthroscopic Superior Capsular Reconstruction

The management of irreparable rotator cuff tears is a difficult problem to deal with. The options include nonoperative route with anterior deltoid exercises, debridement with or without long head of biceps tenotomy, partial rotator cuff repair, tuberoplasty, muscle transfer, patch augmentation, biodegradable spacers, and reverse shoulder arthroplasty. None of these options are without their limitations. In recent years, arthroscopic superior capsular reconstruction has gained popularity as an alternative technique to address irreparable rotator cuff tears. Arthroscopic superior capsular reconstruction, however, is technically difficult. The purpose of this technical note is to describe a simple and reproducible technique for this procedure that addresses some of the challenges involved.