[Objective]To introduce the surgical technique and preliminary clinical outcomes of arthroscopic superior fulcrum recon-struction(SFR)for irreparable massive rotator cuff tears(IMRCT).[Methods]From January 2020 to June 2022,18 patients underwent ar-throscopic SFR for IMRCT.The rotator cuff stumps and bursa tissue were examined and debrided firstly,and the long head biceps tendon was cut or fixed according to the concrete situation.The ipsilateral peroneus longus tendon was harvested 13～15 cm in length and 2～3 mm in diameter.The tendon was divided into two bundles and braided with sutures.Bone tunnels were established on the glenoid side and the head side of the humerus respectively,and the tendons were introduced through the bone tunnel by PDS suture.Finally,the tendons were knotted on the lateral end of the proximal humerus.[Results]All the 18 patients had arthroscopic surgery completed successfully without serious complications,such as nerve and vascular injury,and followed up from 12 to 24 months.Compared with those preoperatively,the VAS[(7.2±1.2),(0.5±0.5),P＜0.001],CMS[(21.1±3.0),(80.3±2.7),P＜0.001],UCLA[(5.9±1.2),(31.4±1.3),P＜0.001]and ASES scores[(34.1±6.0),(85.3±3.8),P＜0.001]improved significantly at the latest follow-up.Radiographically,the acromiohumeral distance(AHD)significantly in-creased postoperatively compared with that preoperatively[(0.5±0.1)cm,(0.9±0.1)cm,P＜0.001],and the graft remained in good appear-ance on images.[Conclusion]The arthroscopic superior fulcrum reconstruction is feasible with a reliable short-term clinical consequence for the huge irreparable rotator cuff tear.
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