📌 Superior Capsular Reconstruction (SCR): Postoperative MRI

https://youtube.com/shorts/rezCclobdPk

https://youtu.be/13TXf_icu9g

 

Superior capsular reconstruction (SCR) is performed for irreparable posterosuperior rotator cuff tears, most commonly massive supraspinatus tears with severe medial retraction and poor tissue quality.

Key concept:
SCR is not a rotator cuff repair.
The goal is restoration of superior stability, not tendon healing.

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What MRI Must Answer After SCR

When reading a postoperative MRI, ask one question only:

Is the graft still functioning as a superior stabilizer?

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Normal / Intact SCR MRI Findings

1. Graft continuity

• Continuous low-signal graft from superior glenoid to greater tuberosity
• No full-thickness fluid gap traversing the graft
• Small fenestrations in dermal allograft are acceptable if continuity is preserved

2. Graft signal

• Homogeneous low signal on T1, T2, and fluid-sensitive sequences
• Mild increased signal at medial or lateral interfaces is common
• Anchor-related signal change is expected

3. Fixation

• No definite gap, retraction, or detachment from anchors
• Small interface fluid or anchor cystic change ≠ failure

4. Humeral head position (most important)

• Humeral head should not be markedly superiorly subluxated
• Mild cranial migration can still be compatible with a functioning graft
• Marked superior migration = functional failure, even if graft remnants remain

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Take-Home Message

Post-SCR MRI interpretation is not about graft perfection.
It is about mechanical function.

If the graft is continuous and superior stability is maintained,
the SCR is functioning.

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#SuperiorCapsularReconstruction #SCR #ShoulderMRI #PostoperativeMRI #RotatorCuffTear #IrreparableCuff #MSKRadiology #OrthopedicImaging #SportsRadiology

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