Editorial Commentary: Superior Capsular Reconstruction-Improved Superior Stability and Functional Deltoid Reverse Pseudoparalysis in Patients With Irreparable Rotator Cuff Tears.

Since I reported clinical and biomechanical improvement after superior capsular reconstruction (SCR) for irreparable rotator cuff tears in 2012 and 2013, many shoulder surgeons around the world have started to perform SCR. However, most of these surgeons are still on the learning curve, and their clinical results are not consistent because clinical outcomes after SCR are correlated with graft healing, which is affected by the surgeon's skill. In cases in which the graft does heal, active shoulder elevation increases after SCR even in patients with pseudoparalysis before surgery. These patients can elevate the arm using the deltoid muscle when superior shoulder stability is restored after SCR. When patients whose grafts have healed cannot elevate the arm even after SCR, they may have concomitant cervical radiculopathy, which causes real paralysis.