Editorial Commentary: Superior Capsular Reconstruction Graft Continuity on Magnetic Resonance Imaging Does Not Necessarily Reflect Structural Competence.

Superior capsular reconstruction is a surgical procedure used for treating massive irreparable rotator cuff tears by restoring joint biomechanics and stability using a graft construct. Evaluating postoperative success has often involved magnetic resonance imaging studies to assess the integrity and durability of the reconstructed grafts. However, an intact-appearing superior capsular reconstruction graft on magnetic resonance imaging may not always represent a functionally competent construct, especially in the setting of progressive graft thinning and humeral head migration over time. As such, surgeons and researchers should interpret postoperative magnetic resonance imaging findings with caution. Superior capsular reconstruction success should not be defined solely by graft continuity, but rather by the combined assessment of joint biomechanics, graft morphology, and patient-reported outcomes.