The course
Two days at Dr Stephen Burkhart's Cowboy Way Shoulder Course in San Antonio, Texas. A worthwhile course.
The laboratory
The lab was set up with 30 cadaver surgical training stations. Facilities on that scale allow a full course of surgeons to work through a technique simultaneously under supervision, which is difficult to arrange and makes a real difference to how much is retained.
Pictured performing a superior capsular reconstruction. With thanks to Arthrex, whose commitment to research and development and to surgeon teaching is substantial.
What superior capsular reconstruction is
Superior capsular reconstruction is one of the options considered for a rotator cuff tear that cannot be repaired. Where a tendon has retracted, thinned or degenerated past the point at which it can be brought back and held to the bone, a graft is instead fixed between the top of the socket and the ball of the shoulder. The graft acts as a restraint, holding the ball down against the socket so that the remaining muscles can move the arm rather than the ball riding upwards. It sits alongside other options for irreparable tears, including partial repair, tendon transfer and reverse shoulder replacement, and the choice depends on the individual shoulder. Individual results vary.
Why cadaver laboratory practice matters
A procedure of this kind involves a sequence of steps performed in a confined space through keyhole incisions, with a graft that has to be measured, prepared, passed and fixed in the right order. Working through it on a cadaveric specimen allows each step to be attempted, repeated and corrected by faculty standing alongside, without time pressure and without consequence to a patient. Thirty stations means every surgeon on the course performs the operation rather than watching someone else perform it.
Related information
See also our post on the Texas shoulder course and our posts on superior capsular reconstruction, together with our rotator cuff tear and rotator cuff repair pages.