 Complex rotator cuff tears are a difficult problem to treat. The new milmy evasive arthroscopic superior capsule reconstruction rebuilds a rotator cuff from scratch. I'm Dr. Mohit Galotra, Associate Professor of Orthopedics at the University of Maryland School of Medicine, and today we're drawing outside the lines. So the shoulder's joint is a ball and socket, and the rotator cuff is the tissue that covers that entire ball and socket. Here's our ball and socket, and the rotator cuff usually is here, but the setting of a large tear can be all the way retracted into the chest here. In addition to your ball and socket joint, you also have your scapula, which sits above your rotator cuff here. Now what causes pain in this setting is not just a tear that's pulled back, but also you no longer have the cushion between the ball here and the scapula above it. And when those two bones hit, that causes pain when you try to raise your arm. So in arthroscopic superior capsule reconstruction, we're taking small amount of tissue from someone else, putting it through small holes in the skin here, and rebuilding a new rotator cuff. So this tissue gets attached to the ledge here on the ball, and all the way here and attached to the socket. Thus providing a new mattress for the shoulder so that these two bones can no longer hit. And second, it keeps the ball down on the socket, making it easier to raise your arm. It seems to be best for active patients who have goals not only for daily life, but also for sports. So in summary, for complex rotator cuff tears, where the tears are so big that they have a 90% failure rate if you try to fix it, an arthroscopic superior capsule reconstruction has a much higher success rate, which provides excellent pain relief, function for daily activities, and return to sport.