Chronic massive rotator cuff tears are challenging to repair completely because of the development of tendon retraction with inelasticity, muscle atrophy and fatty infiltration. The objective of this study was to investigate the clinical outcome and MRI findings after arthroscopic superior capsule reconstruction (ASCR) for symptomatic irreparable rotator cuff tears. From 2011 to 2013, 12 shoulders in 12 consecutive patients (mean, 70.8 years) with irreparable massive rotator cuff tears underwent ASCR using fascia lata. We used suture anchors to attach the graft medially to the glenoid superior tubercle and laterally to the greater tuberosity as same technique by Mihata et al. We added side-to-side sutures between the graft and infraspinatus tendon and between the graft and residual anterior supraspinatus/subscapularis tendon to improve force coupling. Physical examination, clinical rating system, and magnetic resonance imaging (MRI) were performed before surgery; at 6 and 12 months after surgery; and 6 months thereafter. Average follow-up was 19.1 months (12 to 28 months) after surgery. We assessed patients preoperatively by using the scoring systems of the shoulder index of the American Shoulder and Elbow Surgeons (ASES), the Japanese Orthopaedic Association, and the University of California, Los Angeles.Purpose
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