Return to Sports and Physical Work After Arthroscopic Superior Capsule Reconstruction Among Patients With Irreparable Rotator Cuff Tears Teruhisa Mihata, * yz§k MD, PhD, Thay Q. Lee, z§ PhD, Kunimoto Fukunishi, y MD, Yasuo Itami, y MD, Yukitaka Fujisawa, y MD, PhD, Takeshi Kawakami, y MD, PhD, Mutsumi Ohue, k MD, and Masashi Neo, y MD, PhD Investigation performed at Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan Background: Although sports participation and heavy physical work can contribute to rotator cuff tears, many patients expect to return to these activities after surgery; however, irreparable rotator cuff tears can preclude this outcome. A new surgical treatment— arthroscopic superior capsule reconstruction (SCR)—restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function and relieves pain. Purpose: To evaluate the rates of return to sports and physical work among patients treated with arthroscopic SCR. Study Design: Cohort study; Level of evidence, 3. Methods: From 2007 to 2014, we performed arthroscopic SCR in 105 patients with irreparable rotator cuff tears, 5 of whom were lost to follow-up. Consequently, 100 patients (mean age, 66.9 years; range, 43-82 years) were enrolled in the study. Before sur- gery, 26 patients had participated in sports (2 competitive, 24 recreational), and 34 patients had physical work. Rates of return to sports and physical work, the American Shoulder and Elbow Surgeons (ASES) score, active shoulder range of motion, and rate of graft tear were evaluated. The mean time to final follow-up was 48 months (range, 24-88 months). Results: All 26 patients who played sports before their injuries returned fully to them. In addition, 32 patients returned fully to their previous physical work, whereas the 2 remaining patients returned with reduced hours and workloads. As compared with the non- sports group, the sports group had significantly higher postoperative active elevation (160° 6 32° vs 146° 6 39°; P = .04) and higher postoperative ASES scores (97 6 7 vs 91 6 12; P = .02). The shoulder range of motion and ASES scores before and after surgery did not differ significantly between the physical and nonphysical work groups (P = .11-.99). The rate of graft tear did not differ between the sports group (4%) and nonsports group (5%) (P = .75) and between the physical work group (6%) and non- physical work group (5%) (P = .77). Conclusion: Arthroscopic SCR restored shoulder function and resulted in high rates of return to recreational sports and physical work. Keywords: physical work; reconstruction; rotator cuff; sports; superior capsule; tear Although sports participation and heavy physical work can contribute to rotator cuff tears, many patients expect to return to these pursuits after surgery. In case of reparable rotator cuff tears, arthroscopic repair achieves high rates of return to sports and work. 4,9,10,12,21,23 However, when the torn rotator cuff tendons are irreparable, return to sports and heavy labor can be difficult even after surgery. Although surgical options for irreparable rotator cuff tears improve patients’ abilities to perform activities of daily living, many of these techniques fail to restore shoulder function com- pletely, thus preventing full return to participation in sports or jobs that require heavy physical labor. Several recent stud- ies reported the rate of return to sports after reverse total shoulder arthroplasty, a widely popular surgery for irrepara- ble rotator cuff tears. 3,5,11 In particular, patients undergoing reverse total shoulder arthroplasty had an 85% rate of return to at least 1 sporting activity after surgery. 5 However, few patients were able to return to any overhead sport, even at a recreational level, 5 because reverse total shoulder arthro- plasty creates a nonphysiologic shoulder joint. For irreparable rotator cuff tears, we developed a new sur- gical treatment—arthroscopic superior capsule reconstruction The American Journal of Sports Medicine 1–7 DOI: 10.1177/0363546517753387 Ó 2018 The Author(s) 1