Zastrow RK, et al. - Studies reporting clinical outcomes of irreparable rotator cuff tears managed by superior capsule reconstruction (SCR) were systematically reviewed by the researchers in order to assess the preliminary clinical outcomes and complications of SCR for irreparable rotator cuff tears. With a weighted mean follow-up of 27.7 ± 17.3 months, five studies (285 patients, 291 shoulders) of level III-IV evidence were involved. Improvement in forward flexion, external rotation, and internal rotation from 91°-130° preoperatively to 147°-160° postoperatively, from 26°-41° to 41°-45°, and from L4-L1 to L1, respectively. American Shoulder and Elbow Surgeons scores and visual analog scale pain scores progressed from 36-52.2 to 77.5-92 and declined from 4.0-6.3 to 0.4-1.7, respectively. Radiographically, acromiohumeral intervals (AHIs) with acellular dermal allograft varied from 4.5 to 7.1 mm preoperatively, advancing to 7.6-10.8 mm instantly postoperation before reducing to 6.7-9.7 mm by final follow-up. Complications and graft failure rates, respectively, were 17.2% and 11.7%. Hence, in shoulder functionality and pain decrease, preliminary results of SCR exhibited constant improvement. Nonetheless, a reduction in postoperative AHIs showed dermal allograft elongation and persistent superior migration of the humerus, potentially adding to later graft failure.