目的 比较关节镜下上支点重建术与上关节囊重建术治疗不可修复性巨大肩袖撕裂的临床疗效，从而为临床提供更多选择。 方法 选取安徽医科大学第三附属医院骨科2021年9月到2023年7月不可修复性巨大肩袖撕裂患者28例，行关节镜下上支点重建术14例（上支点重建组），上关节囊重建术14例（上关节囊重建组）。观察指标为手术时间、肩关节主动活动度、UCLA、ASES、CMS及VAS评分。 结果 所有患者手术顺利且术后随访至少12个月。两组术后肩关节主动活动度、UCLA、ASES及CMS评分相比差异有统计学意义（P < 0.05），上支点重建组优于上关节囊重建组；两组术后视觉VAS评分、手术时间及术中出血量差异无统计学意义（P > 0.05）。 结论 关节镜下上支点重建治疗不可修复性巨大肩袖撕裂的临床效果更优，值得临床推广。

Objective Toobserve the clinical efficacy of arthroscopic superior fulcrum reconstruction versus superior capsule reconstruction in the treatment of irreparable massive rotator cuff tears， in order to provide more therapeutic choices. Methods A total of 28 patients with irreparable massive rotator cuff tears， who had been admitted to the Department of Orthopedics， the Third Affiliated Hospital of Anhui Medical University from September 2021 to July 2023 were selected， 14 of whom underwent arthroscopic superior fulcrum reconstruction（superior fulcrum reconstruction group）and 14 underwent arthroscopic superior capsule reconstruction（superior capsule reconstruction group）. The observation indexes were operative time， intraoperative blood loss， shoulder joint active range of motion， the university of California at Los Angeles shoulder rating scale（UCLA）， American Shoulder and Elbow Surgeons′ score （ASES）， the shoulder score of Constant-Murley（CMS） and Visual Analogue Scale （VAS）. Results All patients had a successful surgery and a postoperative follow-up was at least 12 months. The postoperative shoulder joint active range of motion， UCLA， ASES and CMS between the two groups， which were statistically significant （P < 0.05）， superior fulcrum reconstruction group was better than superior capsule reconstruction group. There was no significant difference in postoperative VAS， operative time or intraoperative blood loss between the two groups （P > 0.05）. Conclusions Arthroscopic superior fulcrum reconstruction outperforms superior capsule reconstruction in the treatment of irreparable massive rotator cuff tears.