Hazra M.E.D.Hazra R.O.D.Hanson J.A.Ganokroj P.Vopat M.L.Rutledge J.C.Yamaura K.Suppauksorn S.Millett P.J.Mahidol University2023-05-192023-05-192023-01-01EFORT Open Reviews Vol.8 No.1 (2023) , 35-4423967544https://repository.li.mahidol.ac.th/handle/20.500.14594/82538• While functional reconstruction of massive irreparable rotator cuff tears remains a challenge, current techniques aimed at recentering and preventing superior migration of the humeral head allow for clinical and biomechanical improvements in shoulder pain and function. • Recentering of the glenohumeral joint reduces the moment arm and helps the deltoid to recruit more fibers, which compensates for insufficient rotator cuff function and reduces joint pressure. • In the past, the concept of a superior capsular reconstruction with a patch secured by suture anchors has been used. • However, several innovative arthroscopic treatment options have also been developed. • The purpose of this article is to present an overview of new strategies and surgical techniques and if existing present initial clinical results. • Techniques that will be covered include rerouting the long head of the biceps tendon, utilization of the biceps tendon as an autograft to reconstruct the superior capsule, utilization of a semitendinosus tendon allograft to reconstruct the superior capsule, superior capsular reconstruction with dermal allografts, and subacromial spacersMedicineArticleSCOPUS10.1530/EOR-22-00152-s2.0-8515093237720585241