An Arthroscopic Upper Superior Capsule Reconstruction Using a U-Fold Long Head of the Biceps Tendon Autograft for the Treatment of Irreparable Massive Rotator Cuff Tears

We describe an arthroscopic technique utilizing the long head of the biceps tendon (LHBT) for U-fold reconstruction of the upper articular capsule in treating irreparable massive rotator cuff tears. For patients with irreparable massive rotator cuff tears but intact LHBT, the U-fold LHBT is further sutured to the retracted rotator cuff tissues to achieve bridging. This technique aims to reinforce the superior capsular constraint and facilitate integration with the remaining rotator cuff tissue. It emphasizes graft preparation and fixation without the need for additional biomaterials, offering a potential alternative in the surgical treatment of irreparable massive rotator cuff defects.