Date of Award
Master of Physician Assistant Studies (MPAS)
Physician Assistant Studies
superior capsular reconstruction; reverse shoulder arthroplasty in young patients; massive irreparable rotator cuff tear
The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Early diagnosis and identification of rotator cuff injuries are paramount for the appropriate treatment to be facilitated. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and is a challenging procedure. Historically, treatment options have been limited for the young population to invasive surgical intervention or conservative measures such as physical therapy and pharmacologic measures. Surgical approaches to treatment may include a reverse shoulder arthroplasty (RSA) or a superior capsular reconstruction (SCR). The purpose of this study is to determine if a superior capsular reconstruction is a better alternative than a reverse shoulder arthroplasty in the young, active population with a massive irreparable rotator cuff tear. Currently, evidence-based practice proves that SCR is a viable treatment option in the younger population. An SCR has shown successful short-term outcomes and utilizes an anatomical approach. Each surgical option is feasible; however, the postoperative degree of functionality is the substantial difference between either surgical technique. Research has proven the efficacy of the SCR versus the RSA. Although there is limited current evidence-based research in the field of longevity and its potential outcomes, the SCR is the leading surgical option for massive irreparable rotator cuff tears repairs in the young, active patient.
Emmanuel, Hernandez, "Superior Capsular Reconstruction in the Active Population with a Massive Irreparable Rotator Cuff Tear" (2018). Physician Assistant Scholarly Project Papers. 13.