Superior Capsule Reconstruction Augmentation for Massive Rotator Cuff Repair Using the Long Head of the Biceps Tendon

Managing massive rotator cuff tears in patients with minimal arthropathy who maintain an active lifestyle remains a significant challenge for orthopaedic surgeons. There is still uncertainty regarding which joint-preserving surgical techniques offer the best clinical and functional outcomes while minimizing the risk of retears. For some time, superior capsular repair has been used to treat massive rotator cuff tears through the ability to restore glenohumeral stability and function, decrease superior capsular distance, and provide biologic augmentation. The use of the long head of the biceps tendon as augmentation for irreparable rotator cuff tears provides support while reducing concerns associated with allograft viability, rejection, infection, and costs. In this Technical Note, we present our preferred surgical technique for superior capsular repair with long head of the biceps tendon, with successful recovery of range of motion, strength, and function of the shoulder at a minimum of 2 years postoperatively.